Provider Demographics
NPI:1861587248
Name:KLEINER, KARIN JUNGERY
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:JUNGERY
Last Name:KLEINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:(NONE)
Other - Last Name:JUNGERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1980 MOUNTAIN BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611
Mailing Address - Country:US
Mailing Address - Phone:510-339-6600
Mailing Address - Fax:510-531-1403
Practice Address - Street 1:1980 MOUNTAIN BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611
Practice Address - Country:US
Practice Address - Phone:510-339-6600
Practice Address - Fax:510-531-1403
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA MFC14013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist