Provider Demographics
NPI:1063503159
Name:DE BECK, KARLA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:KARLA
Middle Name:LYNN
Last Name:DE BECK
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 1:1 CALIFORNIA ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5424
Mailing Address - Country:US
Mailing Address - Phone:800-997-6196
Mailing Address - Fax:
Practice Address - Street 1:2345 RICE ST STE 230
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3769
Practice Address - Country:US
Practice Address - Phone:800-997-6196
Practice Address - Fax:833-523-9924
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP9362084P0800X
MO20200042002084P0800X
ARE-129112084P0800X
SC835692084F0202X, 2084P0800X
CODR.00636512084P0800X
PAMD067803L2084P0800X
NC95000562084P0800X
MI43015014052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902285Medicaid
2290779AMedicare ID - Type Unspecified
NC5902285Medicaid