Basic Information
| Provider Information | |||||||||
| NPI: | 1952623514 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SERGI | ||||||||
| FirstName: | KARINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9535 RESEDA BLVD STE 112 | ||||||||
| Address2: | |||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913246022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8182717180 | ||||||||
| FaxNumber: | 8184500636 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 20TH ST STE 540 | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105827612 | ||||||||
| FaxNumber: | 4242776342 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2010 | ||||||||
| LastUpdateDate: | 08/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.