Provider Demographics
NPI:1306419387
Name:CARRANZA, ALICIA ORTENCIA (MCHES, NBC-HWC, CTSS)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:ORTENCIA
Last Name:CARRANZA
Suffix:
Gender:F
Credentials:MCHES, NBC-HWC, CTSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 W GARVEY AVE UNIT 978
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-9445
Mailing Address - Country:US
Mailing Address - Phone:949-284-6770
Mailing Address - Fax:
Practice Address - Street 1:600 N ATLANTIC BLVD APT 510
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-7753
Practice Address - Country:US
Practice Address - Phone:949-284-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24253171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty