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General NPI Number Information
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NPI Number | 1003914052
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Entity Type | Individual
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Provider Name | KAREN SUE ROSS MSW IN CALIF LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12377 LEWIS ST SUITE # 104
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City | GARDEN GROVE
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State | CA
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Zip | 92840-4691
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Country | US
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Telephone | 714-703-1366
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Fax | 714-750-0464
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Provider Business Mailing Address
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Address Line | 12377 LEWIS ST SUITE # 104
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City | GARDEN GROVE
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State | CA
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Zip | 92840-4691
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Country | US
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Telephone | 714-703-1366
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Fax | 714-750-0464
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LCS7205
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License Number State | CA
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