Provider Demographics
NPI:1285209668
Name:LEIPER, KARLA A (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:A
Last Name:LEIPER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 DOUGLAS BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4266
Mailing Address - Country:US
Mailing Address - Phone:916-999-9999
Mailing Address - Fax:
Practice Address - Street 1:2235 DOUGLAS BLVD STE 500
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4266
Practice Address - Country:US
Practice Address - Phone:916-747-3799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty