Provider Demographics
NPI:1104286137
Name:TRONNES, CARSHENA
Entity type:Individual
Prefix:MS
First Name:CARSHENA
Middle Name:
Last Name:TRONNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 OREGON CT
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-2645
Mailing Address - Country:US
Mailing Address - Phone:310-320-1333
Mailing Address - Fax:310-320-6555
Practice Address - Street 1:2909 OREGON CT
Practice Address - Street 2:SUITE A-1
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-2645
Practice Address - Country:US
Practice Address - Phone:310-320-1333
Practice Address - Fax:310-320-6555
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-12597103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst