Provider Demographics
NPI:1851672505
Name:PARRA, ILIAM G (MSW)
Entity Type:Individual
Prefix:
First Name:ILIAM
Middle Name:G
Last Name:PARRA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 SARASOTA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2372
Mailing Address - Country:US
Mailing Address - Phone:408-464-0071
Mailing Address - Fax:
Practice Address - Street 1:2039 SARASOTA AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2372
Practice Address - Country:US
Practice Address - Phone:408-464-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker