Provider Demographics
NPI:1083647242
Name:KARLSSON, GUNILLA MARGARETA (PHD)
Entity Type:Individual
Prefix:DR
First Name:GUNILLA
Middle Name:MARGARETA
Last Name:KARLSSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7148
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91359-7148
Mailing Address - Country:US
Mailing Address - Phone:818-991-5244
Mailing Address - Fax:818-706-3127
Practice Address - Street 1:42544 10TH ST W
Practice Address - Street 2:SUITE G
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-7079
Practice Address - Country:US
Practice Address - Phone:661-940-7171
Practice Address - Fax:661-940-9080
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11072103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL110720OtherBLUE SHIELD OF CALIFORNIA
CA0PL110720OtherBLUE SHIELD OF CALIFORNIA