Healthcare Provider Details

I. General information

NPI: 1487808655
Provider Name (Legal Business Name): KAREN L SKOREM M.A., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3595 UNIVERSITY AVE SUITE E
RIVERSIDE CA
92501-3328
US

IV. Provider business mailing address

3595 UNIVERSITY AVE SUITE E
RIVERSIDE CA
92501-3328
US

V. Phone/Fax

Practice location:
  • Phone: 951-212-6414
  • Fax:
Mailing address:
  • Phone: 951-212-6414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC51148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: