Provider Demographics
NPI:1073731675
Name:NARAGON, CARLA (MFT)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:NARAGON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:MARTIN-NARAGON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:1151 DOVE ST
Mailing Address - Street 2:SUITE 245
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2840
Mailing Address - Country:US
Mailing Address - Phone:714-225-0286
Mailing Address - Fax:
Practice Address - Street 1:1151 DOVE ST
Practice Address - Street 2:SUITE 245
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2840
Practice Address - Country:US
Practice Address - Phone:714-225-0286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT37509106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist