Provider Demographics
NPI:1487674412
Name:PECORA, KAREN A (LM)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:PECORA
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32295-8 MISSION TRAIL
Mailing Address - Street 2:#162
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530
Mailing Address - Country:US
Mailing Address - Phone:951-970-5437
Mailing Address - Fax:951-678-3171
Practice Address - Street 1:16336 GRAND AVE
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-1421
Practice Address - Country:US
Practice Address - Phone:951-970-5437
Practice Address - Fax:951-678-3171
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA160176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife