Healthcare Provider Details

I. General information

NPI: 1457734832
Provider Name (Legal Business Name): KARENA LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARENA MALMGREN

II. Dates (important events)

Enumeration Date: 07/03/2015
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6310 SAN VICENTE BLVD STE 415
LOS ANGELES CA
90048-5457
US

IV. Provider business mailing address

6310 SAN VICENTE BLVD STE 415
LOS ANGELES CA
90048-5457
US

V. Phone/Fax

Practice location:
  • Phone: 323-505-2513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number107334
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: