Organization
KAREN E DYMOND PHD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE PHILIP LENZ MFT (CFO)
(714) 447-8782
Entity
Organization
Contact information
Practice address
1480 S HARBOR BLVD, SUITE 14, LA HABRA, CA 90631-7534
(714) 447-8782
(714) 447-9386
Mailing address
1480 SOUTH HARBOR BLVD, SUITE 14, LA HABRA, CA 90631-7534
(714) 447-8782
(714) 447-9386
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W16671
MEDICARE ID
CA
Enumeration date
04/12/2007
Last updated
01/30/2018
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