Provider Demographics
NPI:1124179155
Name:DANYLCHUK, KAREN LYNETTE SCHWARZ (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNETTE SCHWARZ
Last Name:DANYLCHUK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 W 4TH AVE
Mailing Address - Street 2:STE B
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1616
Mailing Address - Country:US
Mailing Address - Phone:650-773-4476
Mailing Address - Fax:650-349-3255
Practice Address - Street 1:4 W 4TH AVE
Practice Address - Street 2:STE B
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1619
Practice Address - Country:US
Practice Address - Phone:650-773-4476
Practice Address - Fax:650-349-3255
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY13668103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL136680Medicare PIN