Provider Demographics
NPI:1730519398
Name:SAUCEDO, KARLA STEPHANIE (MA)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:STEPHANIE
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16251 WOODRUFF AVE APT 62
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-9408
Mailing Address - Country:US
Mailing Address - Phone:323-707-4181
Mailing Address - Fax:
Practice Address - Street 1:119 W TORRANCE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3600
Practice Address - Country:US
Practice Address - Phone:310-347-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No172V00000XOther Service ProvidersCommunity Health Worker