Provider Demographics
NPI:1477858355
Name:JEMISON, KAREN CYNTHIA
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:CYNTHIA
Last Name:JEMISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 N REMBRANDT CIR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5238
Mailing Address - Country:US
Mailing Address - Phone:714-289-1192
Mailing Address - Fax:
Practice Address - Street 1:1540 E 1ST ST
Practice Address - Street 2:SUITE #100
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-6341
Practice Address - Country:US
Practice Address - Phone:714-972-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker