Provider Demographics
NPI:1245594555
Name:NELSON, KAREN LEEANN (LMFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEEANN
Last Name:NELSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34401 LOS GATOS RD
Mailing Address - Street 2:
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210-9423
Mailing Address - Country:US
Mailing Address - Phone:559-362-8585
Mailing Address - Fax:559-934-1667
Practice Address - Street 1:194 E ELM AVE STE 101
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-2800
Practice Address - Country:US
Practice Address - Phone:559-362-8585
Practice Address - Fax:559-362-8585
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117305106H00000X
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist