Provider Demographics
NPI:1083637318
Name:PARKER ANDERSON, KAREN (PHD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PARKER ANDERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6250 TELEGRAPH RD
Mailing Address - Street 2:#1404
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003
Mailing Address - Country:US
Mailing Address - Phone:805-216-4790
Mailing Address - Fax:
Practice Address - Street 1:1200 MARICOPA HWY
Practice Address - Street 2:CLINICAS DEL CAMINO REAL DNE
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023
Practice Address - Country:US
Practice Address - Phone:805-640-8293
Practice Address - Fax:805-640-1410
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13264103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
W3131EMedicare ID - Type Unspecified
CP13264Medicare UPIN