Provider Demographics
NPI:1639574122
Name:HILTON KANANEN, CAROLYN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:HILTON KANANEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 DUNHOLME WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3300
Mailing Address - Country:US
Mailing Address - Phone:408-524-4900
Mailing Address - Fax:408-524-4911
Practice Address - Street 1:572 DUNHOLME WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3300
Practice Address - Country:US
Practice Address - Phone:408-524-4900
Practice Address - Fax:408-524-4911
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 40921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical