Provider Demographics
NPI:1487789905
Name:WILKINSON, KAREN A (PSYD, LMFT)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25301 CABOT RD STE 114
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5511
Mailing Address - Country:US
Mailing Address - Phone:949-951-8369
Mailing Address - Fax:949-586-5860
Practice Address - Street 1:25301 CABOT RD STE 114
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5511
Practice Address - Country:US
Practice Address - Phone:949-951-8369
Practice Address - Fax:949-586-5860
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31101106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist