Provider Demographics
NPI:1053850818
Name:CONTRERAS, KARLENE (MA)
Entity Type:Individual
Prefix:MRS
First Name:KARLENE
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11711 COLLETT AVE APT 2316
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3789
Mailing Address - Country:US
Mailing Address - Phone:951-415-5087
Mailing Address - Fax:
Practice Address - Street 1:662 ENCINITAS BLVD STE 208
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6789
Practice Address - Country:US
Practice Address - Phone:760-815-0768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD7202729103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst