Provider Demographics
NPI:1114664133
Name:TUGGLE-NORD, KARI ANN (LCSW, RD)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:TUGGLE-NORD
Suffix:
Gender:F
Credentials:LCSW, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 BRISTOL ST APT 35
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-8633
Mailing Address - Country:US
Mailing Address - Phone:562-458-7778
Mailing Address - Fax:
Practice Address - Street 1:1330 BRISTOL ST APT 35
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-8633
Practice Address - Country:US
Practice Address - Phone:562-458-7778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1081451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical