Provider Demographics
NPI:1801133277
Name:HANSEN, KAREN LYNN (MFTI, PCI)
Entity type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:LYNN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MFTI, PCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1957
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-0195
Mailing Address - Country:US
Mailing Address - Phone:925-699-8507
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1957
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-0195
Practice Address - Country:US
Practice Address - Phone:925-699-8507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-05
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107241106H00000X
CA73362106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist