Basic Information
Provider Information
NPI: 1003141169
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHLANGER
FirstName: CARINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHLANGER
OtherFirstName: KARIN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MFT
OtherLastNameType: 5
Mailing Information
Address1: 555 MIDDLEFIELD RD
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943012124
CountryCode: US
TelephoneNumber: 6503235457
FaxNumber: 6503235457
Practice Location
Address1: 555 MIDDLEFIELD RD
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943012124
CountryCode: US
TelephoneNumber: 6503235457
FaxNumber: 6503235457
Other Information
ProviderEnumerationDate: 10/07/2009
LastUpdateDate: 10/07/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XMFT28709CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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