Provider Demographics
NPI:1215054937
Name:HURLEY, KAREN CRONIAN (MFT)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:CRONIAN
Last Name:HURLEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:HURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:3454 DYER CT
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1528
Mailing Address - Country:US
Mailing Address - Phone:209-765-2029
Mailing Address - Fax:
Practice Address - Street 1:1015 12TH ST
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-0838
Practice Address - Country:US
Practice Address - Phone:209-765-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18805106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist