Provider Demographics
NPI:1205601622
Name:CAREAGA, ESTHER ALICIA
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:ALICIA
Last Name:CAREAGA
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 1:308 E JUNIPER ST
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-5100
Mailing Address - Country:US
Mailing Address - Phone:928-472-6969
Mailing Address - Fax:
Practice Address - Street 1:308 E JUNIPER ST
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5100
Practice Address - Country:US
Practice Address - Phone:928-472-6969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TM1800X
AZ900157211103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities