Healthcare Provider Details

I. General information

NPI: 1952525602
Provider Name (Legal Business Name): KAREN E DYMOND PHD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 S HARBOR BLVD SUITE 14
LA HABRA CA
90631-7534
US

IV. Provider business mailing address

1480 SOUTH HARBOR BLVD SUITE 14
LA HABRA CA
90631-7534
US

V. Phone/Fax

Practice location:
  • Phone: 714-447-8782
  • Fax: 714-447-9386
Mailing address:
  • Phone: 714-447-8782
  • Fax: 714-447-9386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WAYNE PHILIP LENZ
Title or Position: CFO
Credential: MFT
Phone: 714-447-8782