Healthcare Provider Details

I. General information

NPI: 1063503159
Provider Name (Legal Business Name): KARLA LYNN DE BECK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/10/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 RICE ST STE 230
ROSEVILLE MN
55113-3769
US

IV. Provider business mailing address

1 CALIFORNIA ST STE 2300
SAN FRANCISCO CA
94111-5424
US

V. Phone/Fax

Practice location:
  • Phone: 800-997-6196
  • Fax: 833-523-9924
Mailing address:
  • Phone: 800-997-6196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number83569
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberTP936
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2020004200
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE-12911
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0063651
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD067803L
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9500056
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301501405
License Number StateMI
# 9
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number83569
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: