Provider Demographics
NPI:1235411513
Name:PEKARCIK, KAREN (MSW ASW 34116)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PEKARCIK
Suffix:
Gender:F
Credentials:MSW ASW 34116
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1240
Mailing Address - Street 2:
Mailing Address - City:VALLEY SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95252-1240
Mailing Address - Country:US
Mailing Address - Phone:209-772-2255
Mailing Address - Fax:
Practice Address - Street 1:4250 FOWLER LN STE 204
Practice Address - Street 2:
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619-1987
Practice Address - Country:US
Practice Address - Phone:530-626-3105
Practice Address - Fax:530-642-1233
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 34116101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health