Provider Demographics
NPI:1215654116
Name:CARRANZA, MONICA LORETO RAMIREZ
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LORETO RAMIREZ
Last Name:CARRANZA
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 1:30 E SAN JOAQUIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2946
Mailing Address - Country:US
Mailing Address - Phone:831-424-5033
Mailing Address - Fax:831-424-5044
Practice Address - Street 1:30 E SAN JOAQUIN ST STE 102
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2946
Practice Address - Country:US
Practice Address - Phone:831-424-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
CAMPSS-PUAHIG175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker