Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 76630 | CA |
NPI | 1003063215 |
---|---|
Provider Name | Juliana Carranza |
First Address | Santa Monica, CA 90404-2033 |
Second Address | Santa Monica, CA 90404-2033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 12/05/2017 |