Provider Demographics
NPI:1255614335
Name:ARRIAGA-KUMASAKA, CARMEN E (LMFC)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:E
Last Name:ARRIAGA-KUMASAKA
Suffix:
Gender:F
Credentials:LMFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 LA CIMA ST
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-9711
Mailing Address - Country:US
Mailing Address - Phone:831-566-0427
Mailing Address - Fax:
Practice Address - Street 1:5905 SOQUEL DR
Practice Address - Street 2:SUITE 650
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2855
Practice Address - Country:US
Practice Address - Phone:831-566-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-24
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC14459101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health