Provider Demographics
NPI:1245980358
Name:ST. LEGER, KAREN JEAN (CADC-CAS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JEAN
Last Name:ST. LEGER
Suffix:
Gender:F
Credentials:CADC-CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2452 WILSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-2144
Mailing Address - Country:US
Mailing Address - Phone:714-532-9295
Mailing Address - Fax:714-532-9291
Practice Address - Street 1:2452 WILSHIRE ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-2144
Practice Address - Country:US
Practice Address - Phone:714-532-9295
Practice Address - Fax:714-532-9291
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC037650616101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)