Healthcare Provider Details

I. General information

NPI: 1275756074
Provider Name (Legal Business Name): KAREN LYNNE CONTRERAS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 AGUAJITO RD SUITE 103
MONTEREY CA
93940-4887
US

IV. Provider business mailing address

1200 AGUAJITO RD SUITE 103
MONTEREY CA
93940-4887
US

V. Phone/Fax

Practice location:
  • Phone: 831-647-7652
  • Fax: 831-647-7940
Mailing address:
  • Phone: 831-647-7652
  • Fax: 831-647-7940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number49755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: