Healthcare Provider Details

I. General information

NPI: 1629577820
Provider Name (Legal Business Name): KARINA VENCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2018
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W MORRISON AVE STE C
SANTA MARIA CA
93458-6124
US

IV. Provider business mailing address

PO BOX 7625
SANTA MARIA CA
93456-7625
US

V. Phone/Fax

Practice location:
  • Phone: 805-347-3338
  • Fax:
Mailing address:
  • Phone: 805-878-3335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number141157
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: