Provider Demographics
NPI:1215234646
Name:NARANJO, ED TRINIDAD
Entity type:Individual
Prefix:
First Name:ED
Middle Name:TRINIDAD
Last Name:NARANJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 WENTWORTH ST APT 9
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-4654
Mailing Address - Country:US
Mailing Address - Phone:650-669-9180
Mailing Address - Fax:
Practice Address - Street 1:1084 WENTWORTH ST APT 9
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-4654
Practice Address - Country:US
Practice Address - Phone:650-669-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health