Provider Demographics
NPI:1629593090
Name:KARKOSKA, PAUL DANIEL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:DANIEL
Last Name:KARKOSKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2836 N ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-4116
Mailing Address - Country:US
Mailing Address - Phone:979-324-0116
Mailing Address - Fax:
Practice Address - Street 1:2836 N ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-4116
Practice Address - Country:US
Practice Address - Phone:979-324-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CAIMF111425106H00000X
CA141412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist