Provider Demographics
NPI:1114570447
Name:CESPEDES, KARLI NOEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:KARLI
Middle Name:NOEL
Last Name:CESPEDES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1223
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-1223
Mailing Address - Country:US
Mailing Address - Phone:702-278-3773
Mailing Address - Fax:919-350-7687
Practice Address - Street 1:PO BOX 1223
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1223
Practice Address - Country:US
Practice Address - Phone:213-534-8336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
NC103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1114570447Medicaid