Basic Information
Provider Information
NPI: 1013380468
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIGGINS
FirstName: KAREN
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: CADC I
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DIGGINS
OtherFirstName: KAREN
OtherMiddleName:  
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: CADC I
OtherLastNameType: 2
Mailing Information
Address1: 12890 QUINTA WAY
Address2:  
City: DESERT HOT SPRINGS
State: CA
PostalCode: 922404852
CountryCode: US
TelephoneNumber: 7603292959
FaxNumber: 7603292953
Practice Location
Address1: 12890 QUINTA WAY
Address2:  
City: DESERT HOT SPRINGS
State: CA
PostalCode: 922404852
CountryCode: US
TelephoneNumber: 7603292959
FaxNumber: 7603292953
Other Information
ProviderEnumerationDate: 11/06/2015
LastUpdateDate: 11/06/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XR11451214CAY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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