Healthcare Provider Details

I. General information

NPI: 1487951695
Provider Name (Legal Business Name): CARLA M. MASSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 HIGHLAND ST APT A4
TAUNTON MA
02780-4726
US

IV. Provider business mailing address

145 HIGHLAND ST APT A4
TAUNTON MA
02780-4726
US

V. Phone/Fax

Practice location:
  • Phone: 702-375-1464
  • Fax: 702-204-6293
Mailing address:
  • Phone: 702-375-1464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: