Provider Demographics
NPI:1932684867
Name:HOUSEWORTH, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HOUSEWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1792 TRIBUTE RD STE 350
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4322
Mailing Address - Country:US
Mailing Address - Phone:916-924-6400
Mailing Address - Fax:916-648-1614
Practice Address - Street 1:1792 TRIBUTE ROAD
Practice Address - Street 2:SUITE 350
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815
Practice Address - Country:US
Practice Address - Phone:916-924-6400
Practice Address - Fax:916-648-1614
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty