Provider Demographics
NPI:1790966893
Name:LYNN, KAREN DEBORAH (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DEBORAH
Last Name:LYNN
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 PALO ALTO AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1350
Mailing Address - Country:US
Mailing Address - Phone:650-299-8562
Mailing Address - Fax:
Practice Address - Street 1:710 PALO ALTO AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1350
Practice Address - Country:US
Practice Address - Phone:650-299-8562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS167571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical