Provider Demographics
NPI:1801077888
Name:CAPECE, KAREN CHAN (MSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:CHAN
Last Name:CAPECE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:JIN-OY
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15750 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1012
Mailing Address - Country:US
Mailing Address - Phone:510-667-4901
Mailing Address - Fax:510-667-4964
Practice Address - Street 1:15750 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1012
Practice Address - Country:US
Practice Address - Phone:510-667-4901
Practice Address - Fax:510-667-4964
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18408104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker