Provider Demographics
NPI:1891928743
Name:SPOOR, KAREN (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SPOOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 PACIFIC COAST HIGHWAY
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-2702
Mailing Address - Country:US
Mailing Address - Phone:310-765-0146
Mailing Address - Fax:310-426-9846
Practice Address - Street 1:325 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-3713
Practice Address - Country:US
Practice Address - Phone:310-765-0146
Practice Address - Fax:310-426-9846
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22879103TC1900X
CAPSY22879103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling