Healthcare Provider Details

I. General information

NPI: 1598620650
Provider Name (Legal Business Name): MEYIA CARRASCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 E CALAVERAS BLVD
MILPITAS CA
95035-5411
US

IV. Provider business mailing address

1591 NOBU DR
SAN JOSE CA
95131-3044
US

V. Phone/Fax

Practice location:
  • Phone: 408-586-3210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: