Basic Information
Provider Information
NPI: 1962624841
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARMON-MANCINI
FirstName: KARYN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12742 AMETHYST ST
Address2:  
City: GARDEN GROVE
State: CA
PostalCode: 928452806
CountryCode: US
TelephoneNumber: 5622476150
FaxNumber:  
Practice Location
Address1: 405 W 5TH ST
Address2: STE. 590
City: SANTA ANA
State: CA
PostalCode: 927014599
CountryCode: US
TelephoneNumber: 7148345015
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/02/2007
LastUpdateDate: 10/06/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XRPS2007030CAN Behavioral Health & Social Service ProvidersPsychologistClinical
103TC0700XPSY21494CAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


Home