Provider Demographics
NPI:1669693438
Name:POST, CARON SUE (PHD)
Entity type:Individual
Prefix:MS
First Name:CARON
Middle Name:SUE
Last Name:POST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 AMOROSO PLACE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-3901
Mailing Address - Country:US
Mailing Address - Phone:310-577-9122
Mailing Address - Fax:310-306-1420
Practice Address - Street 1:833 AMOROSO PLACE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-3901
Practice Address - Country:US
Practice Address - Phone:310-577-9122
Practice Address - Fax:310-306-1420
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17038103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical