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General NPI Number Information
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NPI Number | 1770979460
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Entity Type | Individual
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Provider Name | MISS KLARA MARIE PLACEK
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Gender | Female
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 3150 PIO PICO DR STE 105
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City | CARLSBAD
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State | CA
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Zip | 92008-1951
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Country | US
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Telephone | 760-500-3325
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Fax | 858-538-8319
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Provider Business Mailing Address
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Address Line | 125 W MISSION AVE SUITE 103
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City | ESCONDIDO
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State | CA
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Zip | 92025-1720
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Country | US
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Telephone | 760-747-3424
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Fax | 760-747-3435
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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 | 123314
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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