Provider Demographics
NPI:1467015842
Name:KAREN SPRINKEL, INDIVIDUAL & FAMILY TRAUMA THERAPY CORPORATION
Entity Type:Organization
Organization Name:KAREN SPRINKEL, INDIVIDUAL & FAMILY TRAUMA THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:510-918-8424
Mailing Address - Street 1:3511 MONTEREY BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-1606
Mailing Address - Country:US
Mailing Address - Phone:510-918-8424
Mailing Address - Fax:
Practice Address - Street 1:3511 MONTEREY BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-1606
Practice Address - Country:US
Practice Address - Phone:510-918-8424
Practice Address - Fax:510-291-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-21
Last Update Date:2019-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)