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1952680829 NPI number — KAREN M MIKOLIC PH.D.

NPI Number: 1952680829
Health Care Provider/Practitioner: KAREN M MIKOLIC PH.D.

Information about “1952680829” NPI (KAREN M MIKOLIC PH.D.) exists in 1952680829 in HTML format HTML  |  1952680829 in plain Text format TXT  |  1952680829 in PDF (Portable Document Format) PDF  |  1952680829 in an XML format XML  formats.

NPI Number : 1952680829 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952680829",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MIKOLIC",
    "FirstName": "KAREN",
    "MiddleName": "M",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PH.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 2933",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SUNNYVALE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94087-0933",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "858-221-6311",
    "MailingAddressFaxNumber": "888-388-2142",
    "FirstLinePracticeLocationAddress": "10620 TREENA ST STE 230",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92131-1140",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "858-221-6311",
    "PracticeLocationAddressFaxNumber": "888-388-2142",
    "EnumerationDate": "08/10/2011",
    "LastUpdateDate": "12/16/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "PSY1000723",
          "LicenseNumberStateCode": "DC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103G00000X",
          "TaxonomyName": "Clinical Neuropsychologist",
          "LicenseNumber": "PY8438",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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