Healthcare Provider Details

I. General information

NPI: 1902294770
Provider Name (Legal Business Name): DAVID CARRASCO JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2015
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD STE 202
SALINAS CA
93906-3127
US

IV. Provider business mailing address

504 MICHELSON RD
MONTEREY CA
93940-6208
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-1700
  • Fax:
Mailing address:
  • Phone: 210-355-4664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number101884
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number121415
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: