Provider Demographics
NPI:1750312492
Name:DYMOND, KAREN ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELIZABETH
Last Name:DYMOND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1480 S HARBOR BLVD STE 14
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-7570
Mailing Address - Country:US
Mailing Address - Phone:714-447-8782
Mailing Address - Fax:714-447-9386
Practice Address - Street 1:1480 S HARBOR BLVD STE 14
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-7570
Practice Address - Country:US
Practice Address - Phone:714-447-8782
Practice Address - Fax:714-447-9386
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16996103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWCP16996BMedicare PIN