Provider Demographics
NPI:1831222900
Name:SOSA, CARMEN NAOMI (MSW)
Entity type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:NAOMI
Last Name:SOSA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-3463
Mailing Address - Country:US
Mailing Address - Phone:559-457-5400
Mailing Address - Fax:559-457-5490
Practice Address - Street 1:1350 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-3463
Practice Address - Country:US
Practice Address - Phone:559-457-5400
Practice Address - Fax:559-457-5490
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW66850101YM0800X, 1041C0700X
CAASW 273671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAASW 27367OtherASSOCIATE CLINICAL SOCIAL WORKER