Healthcare Provider Details

I. General information

NPI: 1104959634
Provider Name (Legal Business Name): KARLEEN RAE PAQUETTE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3755 VISTA CAMPANA N UNIT 51
OCEANSIDE CA
92057-8118
US

IV. Provider business mailing address

410 NORTHWOOD AVE
BANNING CA
92220-5271
US

V. Phone/Fax

Practice location:
  • Phone: 442-500-4676
  • Fax:
Mailing address:
  • Phone: 626-720-6524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number22385
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: