Provider Demographics
NPI:1942883657
Name:TREPTE, KAREN (MBA, INTERN SCHOOL P)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:TREPTE
Suffix:
Gender:F
Credentials:MBA, INTERN SCHOOL P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-3004
Mailing Address - Country:US
Mailing Address - Phone:707-357-0774
Mailing Address - Fax:
Practice Address - Street 1:1025 CORCORAN AVE
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-1844
Practice Address - Country:US
Practice Address - Phone:707-556-8740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist