Provider Demographics
NPI:1023140001
Name:ENYEDY, KAREN CHICCA (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:CHICCA
Last Name:ENYEDY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ELISE
Other - Last Name:CHICCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6455 COLDWATER CANYON AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY GLEN
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1112
Mailing Address - Country:US
Mailing Address - Phone:818-779-5256
Mailing Address - Fax:818-988-2392
Practice Address - Street 1:6455 COLDWATER CANYON AVE
Practice Address - Street 2:
Practice Address - City:VALLEY GLEN
Practice Address - State:CA
Practice Address - Zip Code:91606-1112
Practice Address - Country:US
Practice Address - Phone:818-779-5256
Practice Address - Fax:818-988-2392
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19612103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical