Provider Demographics
NPI:1700033909
Name:SHUDDE, KARALEA
Entity Type:Individual
Prefix:MISS
First Name:KARALEA
Middle Name:
Last Name:SHUDDE
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 1:137 AERO CAMINO
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-3149
Mailing Address - Country:US
Mailing Address - Phone:805-961-9200
Mailing Address - Fax:805-961-9211
Practice Address - Street 1:137 AERO CAMINO
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-3149
Practice Address - Country:US
Practice Address - Phone:805-961-9200
Practice Address - Fax:805-961-9211
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health