Provider Demographics
NPI:1215251418
Name:CHANDLER, KAREN LEE (LMFT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LEE
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N H ST
Mailing Address - Street 2:SUITE A, PMB 322
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-8138
Mailing Address - Country:US
Mailing Address - Phone:805-588-3013
Mailing Address - Fax:805-737-0346
Practice Address - Street 1:111 S I ST
Practice Address - Street 2:SUITE D
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6700
Practice Address - Country:US
Practice Address - Phone:805-588-3013
Practice Address - Fax:805-737-0346
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 24371106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist