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NPI 1053039230

NPI 1053039230 : KAREN MARIE ASBRA LICENSED MFT : ALTA LOMA, CA

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General NPI Number Information
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    NPI Number           |    1053039230
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    Entity Type          |    Individual 
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    Provider Name        |    KAREN MARIE ASBRA LICENSED MFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/15/2022
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    Last Update Date     |    12/05/2024
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Provider Practice Location Address
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    Address Line         |    8758 ALTA LOMA DR 
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    City                 |    ALTA LOMA
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    State                |    CA
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    Zip                  |    91701-4025
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    Country              |    US
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    Telephone            |    909-489-2935
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8780 19TH ST # 167 
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    City                 |    ALTA LOMA
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    State                |    CA
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    Zip                  |    91701-4608
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    Country              |    US
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    Telephone            |    909-489-2935
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    Fax                  |    
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    150731
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    License Number State |    CA
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