Healthcare Provider Details

I. General information

NPI: 1528325412
Provider Name (Legal Business Name): CARLOS ALBERTO CONTRERAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 OAK RD STE 270
WALNUT CREEK CA
94597-2078
US

IV. Provider business mailing address

2336 TIERRA FABIAN PL
EL PASO TX
79938-2459
US

V. Phone/Fax

Practice location:
  • Phone: 925-944-9711
  • Fax:
Mailing address:
  • Phone: 915-422-9587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA129587
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA129587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: