Provider Demographics
NPI:1891084638
Name:ATKINSON, CAROL H (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:H
Last Name:ATKINSON
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 1:30058 HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:COARSEGOLD
Mailing Address - State:CA
Mailing Address - Zip Code:93614-9675
Mailing Address - Country:US
Mailing Address - Phone:559-696-1270
Mailing Address - Fax:559-658-2164
Practice Address - Street 1:26045 AVENUE 17
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-0690
Practice Address - Country:US
Practice Address - Phone:559-696-1270
Practice Address - Fax:559-658-2164
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14698101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional