Healthcare Provider Details

I. General information

NPI: 1083647242
Provider Name (Legal Business Name): GUNILLA MARGARETA KARLSSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42544 10TH ST W SUITE G
LANCASTER CA
93534-7079
US

IV. Provider business mailing address

PO BOX 7148
THOUSAND OAKS CA
91359-7148
US

V. Phone/Fax

Practice location:
  • Phone: 661-940-7171
  • Fax: 661-940-9080
Mailing address:
  • Phone: 818-991-5244
  • Fax: 818-706-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY11072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: