Individual provider Active NPI

Klara Marie Placek

  • Student in an Organized Health Care Education/Training Program
  • Carlsbad, CA
National Provider Identifier
1770979460
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3150 Pio Pico Dr Ste 105
Carlsbad, CA 92008-1951
Phone
(760) 500-3325
Fax
(858) 538-8319
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 123314 CA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3150 Pio Pico Dr Ste 105
Carlsbad, CA 92008-1951

Mailing address

125 W Mission Ave
Suite 103
Escondido, CA 92025-1720
Phone (760) 747-3424

Other practice location 1

125 W Mission Ave
Suite 103
Escondido, CA 92025-1720
Phone (760) 747-3424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
123314CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1770979460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W MISSION AVE",
            "address_2": "SUITE 103",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920251720",
            "telephone_number": "760-747-3424",
            "fax_number": "760-747-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 PIO PICO DR STE 105",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081951",
            "telephone_number": "760-500-3325",
            "fax_number": "858-538-8319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 W Mission Ave",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920251720",
            "country_code": "US",
            "telephone_number": "760-747-3424",
            "fax_number": "760-747-3435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLACEK",
        "first_name": "KLARA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "123314",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.