Provider Demographics
NPI:1770990806
Name:STAEDLER, KAREN SANCHEZ (PSYD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SANCHEZ
Last Name:STAEDLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-3640
Mailing Address - Country:US
Mailing Address - Phone:209-910-3383
Mailing Address - Fax:866-256-0351
Practice Address - Street 1:3134 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-3640
Practice Address - Country:US
Practice Address - Phone:209-910-3383
Practice Address - Fax:866-256-0351
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA06241225A00000X
CA31753103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty