Provider Demographics
NPI:1548835945
Name:CHENDO, KARENE EFSTRATIS
Entity type:Individual
Prefix:
First Name:KARENE
Middle Name:EFSTRATIS
Last Name:CHENDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BARBAREE WAY
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920-2259
Mailing Address - Country:US
Mailing Address - Phone:415-786-7720
Mailing Address - Fax:
Practice Address - Street 1:105 BARBAREE WAY
Practice Address - Street 2:
Practice Address - City:TIBURON
Practice Address - State:CA
Practice Address - Zip Code:94920-2259
Practice Address - Country:US
Practice Address - Phone:415-786-7720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134620106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist