Provider Demographics
NPI:1053880864
Name:KARWACKI, ANDRZEJ M
Entity type:Individual
Prefix:
First Name:ANDRZEJ
Middle Name:M
Last Name:KARWACKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 SAN PABLO AVE STE 120B
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1694
Mailing Address - Country:US
Mailing Address - Phone:415-335-6327
Mailing Address - Fax:
Practice Address - Street 1:828 SAN PABLO AVE STE 120B
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1694
Practice Address - Country:US
Practice Address - Phone:415-335-6327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92504106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist