Provider Demographics
NPI:1689185043
Name:CARRANZA, MARI ANGELA (NP-C)
Entity Type:Individual
Prefix:
First Name:MARI
Middle Name:ANGELA
Last Name:CARRANZA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 OSSABAW CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5468
Mailing Address - Country:US
Mailing Address - Phone:562-316-8844
Mailing Address - Fax:
Practice Address - Street 1:8311 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3928
Practice Address - Country:US
Practice Address - Phone:562-869-4497
Practice Address - Fax:562-869-3716
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF10170060363LF0000X
CA95008070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily