Provider Demographics
NPI:1497727820
Name:DESOCIO, KAREN ANN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:ANN
Last Name:DESOCIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43466 GADSDEN AVE
Mailing Address - Street 2:APARTMENT 194
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-6165
Mailing Address - Country:US
Mailing Address - Phone:661-277-5292
Mailing Address - Fax:
Practice Address - Street 1:95TH MEDICAL GROUP/SGOHF
Practice Address - Street 2:30 NIGHTINGALE RD
Practice Address - City:EDWARDS AFB
Practice Address - State:CA
Practice Address - Zip Code:93524-0001
Practice Address - Country:US
Practice Address - Phone:661-277-5292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 184511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical