Basic Information
| Provider Information | |||||||||
| NPI: | 1013238484 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAGUNAS | ||||||||
| FirstName: | KARLA | ||||||||
| MiddleName: | FLORES | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20555 DEVONSHIRE ST # 422 | ||||||||
| Address2: | |||||||||
| City: | CHATSWORTH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913113208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104253755 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 26585 AGOURA RD STE 330 | ||||||||
| Address2: | |||||||||
| City: | CALABASAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913021958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103017396 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2010 | ||||||||
| LastUpdateDate: | 12/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LCSW64556 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | 64556 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | LCSW64556 | 01 | CA | BBS LICENSE NUMBER | OTHER |