Provider Demographics
NPI:1710021795
Name:ANDERSON, KARI L (MA)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 S BEVERLY DR STE 11
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4427
Mailing Address - Country:US
Mailing Address - Phone:310-284-9004
Mailing Address - Fax:
Practice Address - Street 1:441 S BEVERLY DR STE 11
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4427
Practice Address - Country:US
Practice Address - Phone:310-284-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19780106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist