Provider Demographics
NPI:1891074019
Name:HERNANDEZ, KAREN KAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:KAY
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:KAY
Other - Last Name:LAMASTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:4651 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95633-9306
Mailing Address - Country:US
Mailing Address - Phone:530-333-2876
Mailing Address - Fax:
Practice Address - Street 1:4651 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:GARDEN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95633-9306
Practice Address - Country:US
Practice Address - Phone:530-333-2876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27849106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist