Provider Demographics
NPI:1013053420
Name:MAHER, KAREN (MFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 HIGHLAND DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2409
Mailing Address - Country:US
Mailing Address - Phone:858-259-8044
Mailing Address - Fax:858-259-8045
Practice Address - Street 1:990 HIGHLAND DR STE 102
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2409
Practice Address - Country:US
Practice Address - Phone:858-259-8044
Practice Address - Fax:858-259-8045
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT021347106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT021347OtherSTATE LICENSE NUMBER