Provider Demographics
NPI:1689225153
Name:CRUM, KAREN ANNE
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNE
Last Name:CRUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4922 SUNNYHILL LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-3510
Mailing Address - Country:US
Mailing Address - Phone:530-227-4018
Mailing Address - Fax:
Practice Address - Street 1:353 PARK MARINA CIR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0965
Practice Address - Country:US
Practice Address - Phone:530-245-9221
Practice Address - Fax:530-245-9222
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty