Provider Demographics
NPI:1063568459
Name:HASTINGS, KAREN E (PSYD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:E
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1094 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-2928
Mailing Address - Country:US
Mailing Address - Phone:310-833-4448
Mailing Address - Fax:310-833-1146
Practice Address - Street 1:1094 W 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-2928
Practice Address - Country:US
Practice Address - Phone:310-833-4448
Practice Address - Fax:310-833-1146
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15124103T00000X
NY014983-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical