Basic Information
Provider Information
NPI: 1972058220
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARIAS
FirstName: KARINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MFTI
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 215 W BEAMER ST
Address2:  
City: WOODLAND
State: CA
PostalCode: 956952510
CountryCode: US
TelephoneNumber: 5304052815
FaxNumber:  
Practice Location
Address1: 215 W BEAMER ST
Address2:  
City: WOODLAND
State: CA
PostalCode: 956952510
CountryCode: US
TelephoneNumber: 5304052815
FaxNumber: 5307582109
Other Information
ProviderEnumerationDate: 08/16/2016
LastUpdateDate: 03/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XLMFT125215CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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