Provider Demographics
NPI:1306053079
Name:KARANTZALIS, MELITZA B (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELITZA
Middle Name:B
Last Name:KARANTZALIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MELITZA
Other - Middle Name:E
Other - Last Name:BATISTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:35222 PRESTON PLACE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3555 WHIPPLE ROAD
Practice Address - Street 2:BLDG A
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587
Practice Address - Country:US
Practice Address - Phone:510-675-2157
Practice Address - Fax:510-675-3550
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS18870104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker