Provider Demographics
NPI:1598994964
Name:NAVAS, KARLA RAQUEL
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:RAQUEL
Last Name:NAVAS
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 1:1339 BETTY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-4213
Mailing Address - Country:US
Mailing Address - Phone:530-723-5577
Mailing Address - Fax:
Practice Address - Street 1:1339 BETTY AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776-4213
Practice Address - Country:US
Practice Address - Phone:530-723-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATD-2009-019172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver