Provider Demographics
NPI:1982678488
Name:GANDY-BIFERNO, KAREN (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GANDY-BIFERNO
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 1:133 E DUARTE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3935
Mailing Address - Country:US
Mailing Address - Phone:626-574-0824
Mailing Address - Fax:626-574-0851
Practice Address - Street 1:133 E DUARTE RD
Practice Address - Street 2:SUITE C
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3935
Practice Address - Country:US
Practice Address - Phone:626-574-0824
Practice Address - Fax:626-574-0851
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6095103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical