Provider Demographics
NPI:1437348331
Name:FRAZIER, CARRIE LEE (LICENSED CLINICAL SO)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:LEE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 VILLA DRIVE
Mailing Address - Street 2:APT. #106
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565
Mailing Address - Country:US
Mailing Address - Phone:925-787-4827
Mailing Address - Fax:
Practice Address - Street 1:301 W. 10TH STREET
Practice Address - Street 2:SUITE #24
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-787-4827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS60471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical