Provider Demographics
NPI:1932226388
Name:STARR-KARLIN, PENELOPE (MFT)
Entity Type:Individual
Prefix:
First Name:PENELOPE
Middle Name:
Last Name:STARR-KARLIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-1325
Mailing Address - Country:US
Mailing Address - Phone:310-391-8718
Mailing Address - Fax:310-391-5861
Practice Address - Street 1:3301 COLBY AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-1325
Practice Address - Country:US
Practice Address - Phone:310-391-8718
Practice Address - Fax:310-391-5861
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37181106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist