Provider Demographics
NPI:1982149548
Name:CARTER, KIANA
Entity type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:CARTER
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 1:2015 PIONEER CT
Mailing Address - Street 2:B
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1781
Mailing Address - Country:US
Mailing Address - Phone:650-348-6603
Mailing Address - Fax:650-638-1602
Practice Address - Street 1:2015 PIONEER CT
Practice Address - Street 2:B
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1781
Practice Address - Country:US
Practice Address - Phone:650-348-6603
Practice Address - Fax:650-638-1602
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator