Basic Information
| Provider Information | |||||||||
| NPI: | 1225353105 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEEK | ||||||||
| FirstName: | KARESA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31625 HIGHWAY 101 S | ||||||||
| Address2: | |||||||||
| City: | SOLEDAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939609529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316785500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2880 ZANKER ROAD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087804174 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2010 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | N | Behavioral Health & Social Service Providers | Psychologist | 103TC0700X | 25767 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.