Provider Demographics
NPI:1811048804
Name:DUNFORD, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DUNFORD
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 1:7484 NIKI LANE
Mailing Address - Street 2:P.O.BOX 443
Mailing Address - City:FORESTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95436
Mailing Address - Country:US
Mailing Address - Phone:707-887-1610
Mailing Address - Fax:
Practice Address - Street 1:1333 7TH ST
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-1801
Practice Address - Country:US
Practice Address - Phone:415-897-7195
Practice Address - Fax:415-897-9687
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health