Healthcare Provider Details

I. General information

NPI: 1588072250
Provider Name (Legal Business Name): KARI ANN PECK LPCC-9983
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 MONTGOMERY ST STE 1400
SAN FRANCISCO CA
94104-1247
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 855-427-2778
  • Fax: 415-561-0244
Mailing address:
  • Phone: 916-576-7900
  • Fax: 661-758-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: