Provider Demographics
NPI:1730457342
Name:CARRANZA, MELISSA ELAINE
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ELAINE
Last Name:CARRANZA
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 1:16403 WILKIE AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-1841
Mailing Address - Country:US
Mailing Address - Phone:310-710-1833
Mailing Address - Fax:
Practice Address - Street 1:16403 WILKIE AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-1841
Practice Address - Country:US
Practice Address - Phone:310-710-1833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor