Provider Demographics
NPI:1073227633
Name:CARRANZA, SARA MICHELE
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MICHELE
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 1:1374 E HILLCREST DR APT 310
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2520
Mailing Address - Country:US
Mailing Address - Phone:805-907-8430
Mailing Address - Fax:
Practice Address - Street 1:1050 N VENTURA RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3855
Practice Address - Country:US
Practice Address - Phone:714-202-0666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician