Provider Demographics
NPI:1609156108
Name:FLEISHER, KAREN JUDITH (MFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JUDITH
Last Name:FLEISHER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1773 PETRA DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-5739
Mailing Address - Country:US
Mailing Address - Phone:619-234-3330
Mailing Address - Fax:
Practice Address - Street 1:1773 PETRA DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-5739
Practice Address - Country:US
Practice Address - Phone:619-234-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC27163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health