Provider Demographics
NPI:1356194062
Name:CHERNEKOFF, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CHERNEKOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SUN TER
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-9230
Mailing Address - Country:US
Mailing Address - Phone:949-291-4296
Mailing Address - Fax:
Practice Address - Street 1:30131 TOWN CENTER DR STE 280
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2086
Practice Address - Country:US
Practice Address - Phone:949-495-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28955106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist