Provider Demographics
NPI:1013328772
Name:CARRERA, HERMAN (ACSW)
Entity type:Individual
Prefix:MR
First Name:HERMAN
Middle Name:
Last Name:CARRERA
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1563 MISSION ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2543
Mailing Address - Country:US
Mailing Address - Phone:628-217-5200
Mailing Address - Fax:415-553-3900
Practice Address - Street 1:1563 MISSION ST STE A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103
Practice Address - Country:US
Practice Address - Phone:628-217-5200
Practice Address - Fax:415-553-3900
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77833104100000X
CA30129104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker