Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 34979 | CA |
NPI | 1003410440 |
---|---|
Provider Name | Dr. Kristy Carranza |
First Address | South San Francisco, CA 94080-2259 |
Second Address | San Carlos, CA 94070-4113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2020 |
Last Update Date | 25/11/2020 |