Provider Demographics
NPI:1417481607
Name:PLEASANT, KARIN (LCSW)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:PLEASANT
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 1:10600 POPLAR ST APT 24
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2357
Mailing Address - Country:US
Mailing Address - Phone:760-709-0779
Mailing Address - Fax:
Practice Address - Street 1:10600 POPLAR ST APT 24
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2357
Practice Address - Country:US
Practice Address - Phone:760-709-0779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2021-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R-DMT-2123225600000X
CA992861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist