Provider Demographics
NPI:1659190874
Name:FARREN, CIARA MAE
Entity type:Individual
Prefix:MRS
First Name:CIARA
Middle Name:MAE
Last Name:FARREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CIARA
Other - Middle Name:MAE
Other - Last Name:ARTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:JULIAN
Mailing Address - State:CA
Mailing Address - Zip Code:92036-0063
Mailing Address - Country:US
Mailing Address - Phone:760-315-6418
Mailing Address - Fax:
Practice Address - Street 1:1704 CAPE HORN AVE.
Practice Address - Street 2:
Practice Address - City:JULIAN
Practice Address - State:CA
Practice Address - Zip Code:92036
Practice Address - Country:US
Practice Address - Phone:760-765-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician