Provider Demographics
NPI:1912061722
Name:MULLER, KAREN M (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:MULLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:M
Other - Last Name:MULLER, LCSW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:718 MARTINELLI ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2714
Mailing Address - Country:US
Mailing Address - Phone:831-601-5424
Mailing Address - Fax:
Practice Address - Street 1:718 MARTINELLI ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2714
Practice Address - Country:US
Practice Address - Phone:831-601-5424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS174381041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ46923ZMedicare UPIN