Provider Demographics
NPI:1134698806
Name:HERRERA, KARINA JEANETTE
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:JEANETTE
Last Name:HERRERA
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 1:16160 KIETH HARROW BLVD APT 810
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5456
Mailing Address - Country:US
Mailing Address - Phone:713-469-8424
Mailing Address - Fax:
Practice Address - Street 1:20627 LAUREL RAIN CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7164
Practice Address - Country:US
Practice Address - Phone:713-469-8424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-24
Last Update Date:2018-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-18-65162106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty