Provider Demographics
NPI:1295523462
Name:HERRON, CAROLYN MCNAGHTEN (LCSW PPSC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MCNAGHTEN
Last Name:HERRON
Suffix:
Gender:
Credentials:LCSW PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1889 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-2166
Mailing Address - Country:US
Mailing Address - Phone:408-423-3627
Mailing Address - Fax:
Practice Address - Street 1:1889 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-2166
Practice Address - Country:US
Practice Address - Phone:408-423-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1275421041C0700X
CA2402083591041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical