Provider Demographics
NPI:1972779213
Name:MCBRIDE, KAREN ANNETTE (MA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNETTE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3934 ANN ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-3815
Mailing Address - Country:US
Mailing Address - Phone:562-425-1506
Mailing Address - Fax:
Practice Address - Street 1:5406 E VILLAGE RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1607
Practice Address - Country:US
Practice Address - Phone:562-429-6552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA LIC.MFC 30635101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health