Provider Demographics
NPI:1538509047
Name:BROWN, KARLA AMANDA (LMFT)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:AMANDA
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 HAVEN AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-1011
Mailing Address - Country:US
Mailing Address - Phone:650-667-0117
Mailing Address - Fax:800-858-5809
Practice Address - Street 1:3705 HAVEN AVE STE 125
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-1011
Practice Address - Country:US
Practice Address - Phone:650-667-0117
Practice Address - Fax:800-858-5809
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103907106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist