Provider Demographics
NPI:1104553783
Name:INIGUEZ, KARLA AIDEE (AMFT)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:AIDEE
Last Name:INIGUEZ
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:
Other - Last Name:INIGUEZ-ZARATE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 70353
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-0353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:936 AZURE ST APT A10
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1401
Practice Address - Country:US
Practice Address - Phone:408-333-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124347106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist