Provider Demographics
NPI:1932926656
Name:WEST, CAROLYN M (BSN, RN, PHN, NCSN)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:M
Last Name:WEST
Suffix:
Gender:F
Credentials:BSN, RN, PHN, NCSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STARLIGHT ELEMENTARY SCHOOL
Mailing Address - Street 2:225 HAMMER DRIVE
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076
Mailing Address - Country:US
Mailing Address - Phone:209-607-1049
Mailing Address - Fax:
Practice Address - Street 1:STARLIGHT ELEMENTARY SCHOOL
Practice Address - Street 2:225 HAMMER DRIVE
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076
Practice Address - Country:US
Practice Address - Phone:209-607-1049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA496156163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool