Provider Demographics
NPI:1114262243
Name:ESPINOSA DE LOS MONTEROS, KARLA (PHD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:ESPINOSA DE LOS MONTEROS
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 1:39500 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2211
Mailing Address - Country:US
Mailing Address - Phone:510-226-5603
Mailing Address - Fax:510-933-0599
Practice Address - Street 1:39500 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2211
Practice Address - Country:US
Practice Address - Phone:510-226-5603
Practice Address - Fax:510-933-0599
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPS2012065103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical