Provider Demographics
NPI:1215036082
Name:COY, KAREN LESLIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LESLIE
Last Name:COY
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 1:918 W AVENUE J
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3429
Mailing Address - Country:US
Mailing Address - Phone:661-433-9342
Mailing Address - Fax:661-945-7023
Practice Address - Street 1:918 W AVENUE J
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3429
Practice Address - Country:US
Practice Address - Phone:661-433-9342
Practice Address - Fax:661-945-7023
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15159103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist