Provider Demographics
NPI:1053752386
Name:JURVETSON, KARLA (MD)
Entity type:Individual
Prefix:DR
First Name:KARLA
Middle Name:
Last Name:JURVETSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27200 ALTAMONT RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-4227
Mailing Address - Country:US
Mailing Address - Phone:650-948-8355
Mailing Address - Fax:
Practice Address - Street 1:350 2ND ST STE 4
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-3602
Practice Address - Country:US
Practice Address - Phone:650-941-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0800682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry