Provider Demographics
NPI:1811623200
Name:ZARAGOZA, CARLA
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:ZARAGOZA
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 1:125 BETHANY DR STE C
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-2803
Mailing Address - Country:US
Mailing Address - Phone:844-322-7483
Mailing Address - Fax:888-334-7021
Practice Address - Street 1:125 BETHANY DR STE C
Practice Address - Street 2:
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-2803
Practice Address - Country:US
Practice Address - Phone:844-322-7483
Practice Address - Fax:888-334-7021
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician