Basic Information
| Provider Information | |||||||||
| NPI: | 1235411513 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEKARCIK | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MSW ASW 34116 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1240 | ||||||||
| Address2: | |||||||||
| City: | VALLEY SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952521240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097722255 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4250 FOWLER LN STE 204 | ||||||||
| Address2: | |||||||||
| City: | DIAMOND SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956191987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306263105 | ||||||||
| FaxNumber: | 5306421233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2011 | ||||||||
| LastUpdateDate: | 02/05/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ASW 34116 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.