Provider Demographics
NPI:1255671707
Name:DEADRICK, KARIMA (LCSW)
Entity Type:Individual
Prefix:
First Name:KARIMA
Middle Name:
Last Name:DEADRICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 AZURE LN
Mailing Address - Street 2:UNIT 2
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-7855
Mailing Address - Country:US
Mailing Address - Phone:909-559-2661
Mailing Address - Fax:
Practice Address - Street 1:10281 KIDD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3414
Practice Address - Country:US
Practice Address - Phone:951-358-3934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29136101YP2500X, 104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker