Provider Demographics
NPI:1689317489
Name:PASCOE, KAREN (AMFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PASCOE
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:KARYN, KIKI
Other - Middle Name:
Other - Last Name:PASCOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AMFT
Mailing Address - Street 1:PO BOX 606
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:CA
Mailing Address - Zip Code:94978-0606
Mailing Address - Country:US
Mailing Address - Phone:415-779-0920
Mailing Address - Fax:
Practice Address - Street 1:300 TAMAL PLZ STE 220
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1136
Practice Address - Country:US
Practice Address - Phone:415-779-0920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130422106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist