Provider Demographics
NPI:1104200336
Name:FLEMMING, CARRIE ANN (MA, CCHT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:FLEMMING
Suffix:
Gender:F
Credentials:MA, CCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 HAIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3232
Mailing Address - Country:US
Mailing Address - Phone:510-907-0075
Mailing Address - Fax:
Practice Address - Street 1:319 LENOX AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4626
Practice Address - Country:US
Practice Address - Phone:510-907-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist