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NPI Code Detail

MEDICARE: KAREN DINORAH DE HARO

MEDICARE: KAREN DINORAH DE HARO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-19-77007CA

General Provider Information

NPI Number : 1043002678
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN DINORAH DE HARO
Provider Business Mailing Address
First Line : 12 STAGE COACH LN
Second Line :
City : CARSON
State : CA
Zip : 90745-5663
Country : US
Telephone Number : 424-210-1620
Fax Number :
Provider Business Practice Location Address
First Line : 11287 WASHINGTON BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4615
Country : US
Telephone Number : 424-210-1620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2025
Last Update Date : 05/20/2025

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Directions to “ KAREN DINORAH DE HARO ” Practice Location

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