Provider Demographics
NPI:1083841787
Name:DAVISON, KAREN M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:DAVISON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 MINNA ST
Mailing Address - Street 2:# 21
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2759
Mailing Address - Country:US
Mailing Address - Phone:510-541-5988
Mailing Address - Fax:
Practice Address - Street 1:701 MINNA ST
Practice Address - Street 2:# 21
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2759
Practice Address - Country:US
Practice Address - Phone:510-541-5988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2014-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22308103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical