Provider Demographics
NPI:1376750364
Name:OUSE, KAREN (LMFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:OUSE
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 1:9515 SOQUEL DR STE 212
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4137
Mailing Address - Country:US
Mailing Address - Phone:831-689-7676
Mailing Address - Fax:844-318-0890
Practice Address - Street 1:9515 SOQUEL DR STE 212
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003
Practice Address - Country:US
Practice Address - Phone:831-689-7676
Practice Address - Fax:844-318-0890
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2018-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 47115106H00000X
CA47829106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA47829OtherLICENSED MARRIAGE & FAMILY THERAPIST
CA47115OtherIMF