Provider Demographics
NPI:1306723150
Name:CLEM, KAREN MARIE (PPS)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:CLEM
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 EDUCATION DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-2767
Mailing Address - Country:US
Mailing Address - Phone:707-542-5197
Mailing Address - Fax:
Practice Address - Street 1:2665 DUTTON MDW
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-7730
Practice Address - Country:US
Practice Address - Phone:707-541-3795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool