Healthcare Provider Details

I. General information

NPI: 1962236851
Provider Name (Legal Business Name): KARLA PADILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2024
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 CENTRAL AVE STE 125
CHINO CA
91710-7202
US

IV. Provider business mailing address

2197 E 19TH ST APT B
SAN BERNARDINO CA
92404-5864
US

V. Phone/Fax

Practice location:
  • Phone: 909-517-2020
  • Fax:
Mailing address:
  • Phone: 323-274-6861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW134997
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: