Provider Demographics
NPI:1821143405
Name:KARNO, MITCHELL PERRY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:PERRY
Last Name:KARNO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 STATE ST
Mailing Address - Street 2:FL 4
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2613
Mailing Address - Country:US
Mailing Address - Phone:805-682-6006
Mailing Address - Fax:
Practice Address - Street 1:1216 STATE ST
Practice Address - Street 2:FL 4
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2613
Practice Address - Country:US
Practice Address - Phone:805-682-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18358103TA0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP18358Medicare PIN