Provider Demographics
NPI:1558588392
Name:MIRANDA, ARACELI (ASW)
Entity Type:Individual
Prefix:MRS
First Name:ARACELI
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:F
Credentials: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 4043
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95063-4043
Mailing Address - Country:US
Mailing Address - Phone:831-426-7322
Mailing Address - Fax:831-426-2803
Practice Address - Street 1:530 SOQUEL AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2301
Practice Address - Country:US
Practice Address - Phone:831-426-7322
Practice Address - Fax:831-426-2803
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15323104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker