Provider Demographics
NPI:1013432756
Name:NACCARATO, C. JUSTICE
Entity Type:Individual
Prefix:MRS
First Name:C. JUSTICE
Middle Name:
Last Name:NACCARATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:JUSTICE
Other - Last Name:NACCARATO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2888 LOKER AVE E STE 113-D
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-6682
Mailing Address - Country:US
Mailing Address - Phone:760-613-8645
Mailing Address - Fax:
Practice Address - Street 1:2888 LOKER AVE E STE 113-D
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6682
Practice Address - Country:US
Practice Address - Phone:760-613-8645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator