Provider Demographics
NPI:1578011953
Name:NARANJO, ADRIANA CORTEZ
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:CORTEZ
Last Name:NARANJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-5424
Mailing Address - Country:US
Mailing Address - Phone:760-726-4900
Mailing Address - Fax:760-631-0778
Practice Address - Street 1:200 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084
Practice Address - Country:US
Practice Address - Phone:760-726-4900
Practice Address - Fax:760-631-0778
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X, 390200000X
CA114706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program