Provider Demographics
NPI:1497772107
Name:KUPKA, KARIN JOY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KARIN
Middle Name:JOY
Last Name:KUPKA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:873 WANDERING RD
Mailing Address - Street 2:APT 2
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6493
Mailing Address - Country:US
Mailing Address - Phone:858-642-3827
Mailing Address - Fax:858-642-1162
Practice Address - Street 1:VA MEDICAL CTR
Practice Address - Street 2:3350 LA JOLLA VILLAGE DRIVE
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0001
Practice Address - Country:US
Practice Address - Phone:858-642-3329
Practice Address - Fax:858-642-1162
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-106771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical