Provider Demographics
NPI:1821232356
Name:MATRANGA, CAROLYN HAAS
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:HAAS
Last Name:MATRANGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N SAN PEDRO RD
Mailing Address - Street 2:SUITE 165
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-4118
Mailing Address - Country:US
Mailing Address - Phone:415-479-7880
Mailing Address - Fax:415-479-7889
Practice Address - Street 1:30 N SAN PEDRO RD
Practice Address - Street 2:SUITE 165
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4118
Practice Address - Country:US
Practice Address - Phone:415-479-7880
Practice Address - Fax:415-479-7889
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5717235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist