Provider Demographics
NPI:1649264821
Name:SEARS, KARYL BECHTOLD (PHD)
Entity type:Individual
Prefix:MS
First Name:KARYL
Middle Name:BECHTOLD
Last Name:SEARS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 CAMINO DEL MAR
Mailing Address - Street 2:#3
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2658
Mailing Address - Country:US
Mailing Address - Phone:858-259-9962
Mailing Address - Fax:858-792-5162
Practice Address - Street 1:1049 CAMINO DEL MAR
Practice Address - Street 2:#3
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2658
Practice Address - Country:US
Practice Address - Phone:858-259-9962
Practice Address - Fax:858-792-5162
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12158103T00000X
MEPS891103T00000X
CAMFC14285106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R15732Medicare UPIN
CP12158Medicare ID - Type Unspecified