Provider Demographics
NPI:1417716135
Name:COLOMER, CARINA ALYSSA (MA, PPSC)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:ALYSSA
Last Name:COLOMER
Suffix:
Gender:F
Credentials:MA, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 PARK TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:GALT
Mailing Address - State:CA
Mailing Address - Zip Code:95632-3766
Mailing Address - Country:US
Mailing Address - Phone:209-745-5465
Mailing Address - Fax:
Practice Address - Street 1:997 PARK TERRACE DR
Practice Address - Street 2:
Practice Address - City:GALT
Practice Address - State:CA
Practice Address - Zip Code:95632-3766
Practice Address - Country:US
Practice Address - Phone:209-745-5462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool