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General NPI Number Information
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NPI Number | 1154697019
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Entity Type | Individual
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Provider Name | CARLA J NOTO-VENCILL M.A., MFT
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Gender | Female
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Dates
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Enumeration Date | 03/26/2012
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Last Update Date | 03/26/2012
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Provider Practice Location Address
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Address Line | 6265 HIGHWAY 9
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City | FELTON
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State | CA
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Zip | 95018-9710
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Country | US
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Telephone | 408-313-2109
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Fax |
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Provider Business Mailing Address
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Address Line | 180 LOCUST LANE
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City | BEN LOMOND
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State | CA
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Zip | 95005-9731
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Country | US
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Telephone | 831-336-0326
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 27403
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License Number State | CA
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