Provider Demographics
NPI:1164994349
Name:SALAIZA, CARINA GARNICA (MSW,ASW)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:GARNICA
Last Name:SALAIZA
Suffix:
Gender:F
Credentials:MSW,ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95353-0688
Mailing Address - Country:US
Mailing Address - Phone:209-604-9046
Mailing Address - Fax:
Practice Address - Street 1:1539 MCHENRY AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4528
Practice Address - Country:US
Practice Address - Phone:209-702-0139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA112267101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical