Provider Demographics
NPI:1831362383
Name:CARREON, LUZ-IDALIA (BA)
Entity type:Individual
Prefix:MS
First Name:LUZ-IDALIA
Middle Name:
Last Name:CARREON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3337 VINCENT RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4354
Mailing Address - Country:US
Mailing Address - Phone:925-753-2156
Mailing Address - Fax:925-753-2157
Practice Address - Street 1:3337 VINCENT RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4354
Practice Address - Country:US
Practice Address - Phone:925-753-2156
Practice Address - Fax:925-753-2157
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator