Healthcare Provider Details

I. General information

NPI: 1689156325
Provider Name (Legal Business Name): KARMEN FLUKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 ELM AVE
PLACERVILLE CA
95667-4711
US

IV. Provider business mailing address

1113 ELM AVE
PLACERVILLE CA
95667-4711
US

V. Phone/Fax

Practice location:
  • Phone: 510-598-0124
  • Fax:
Mailing address:
  • Phone: 510-598-0124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number108648
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAMFT108648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: