Provider Demographics
NPI:1073815072
Name:HANSON BONDI, KAREN LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LEE
Last Name:HANSON BONDI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2240 ENCINITAS BLVD STE D192
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4345
Mailing Address - Country:US
Mailing Address - Phone:858-876-5511
Mailing Address - Fax:858-947-4020
Practice Address - Street 1:12625 HIGH BLUFF DR STE 206
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2053
Practice Address - Country:US
Practice Address - Phone:858-876-5511
Practice Address - Fax:858-947-4020
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23561103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist