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General NPI Number Information
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NPI Number | 1669324075
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Entity Type | Individual
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Provider Name | KARLEE LYN KOEPPEN
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Gender | Female
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 2494 LAKE TAHOE BLVD STE B7
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7142
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Country | US
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Telephone | 530-600-6505
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Fax |
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Provider Business Mailing Address
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Address Line | 2424 SUTTER TRL
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-6807
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Country | US
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Telephone | 530-318-3514
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 20557
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License Number State | CA
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