Provider Demographics
NPI:1184477309
Name:DIETRICH, KARI A (AMFT)
Entity type:Individual
Prefix:MRS
First Name:KARI
Middle Name:A
Last Name:DIETRICH
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 VERNON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6311
Mailing Address - Country:US
Mailing Address - Phone:916-782-1111
Mailing Address - Fax:916-782-4544
Practice Address - Street 1:1780 VERNON ST STE 1
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6311
Practice Address - Country:US
Practice Address - Phone:916-782-1111
Practice Address - Fax:916-782-4544
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist