Provider Demographics
NPI:1326856089
Name:HUMMEL, KAREN JEANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JEANNE
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:JEANNE
Other - Last Name:MCCORMISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:64 VELLISIMO DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-8041
Mailing Address - Country:US
Mailing Address - Phone:949-874-4246
Mailing Address - Fax:
Practice Address - Street 1:64 VELLISIMO DR
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-8041
Practice Address - Country:US
Practice Address - Phone:949-874-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY33759103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical