Provider Demographics
NPI:1245440106
Name:WILBUR, CAROLYN SHIGEMI (MSW)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:SHIGEMI
Last Name:WILBUR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:SHIGEMI
Other - Last Name:KOZEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2745A MAURICIA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-7039
Mailing Address - Country:US
Mailing Address - Phone:408-916-8442
Mailing Address - Fax:
Practice Address - Street 1:2001 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1136
Practice Address - Country:US
Practice Address - Phone:408-261-7777
Practice Address - Fax:408-259-2273
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker