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General NPI Number Information
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NPI Number | 1477064079
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Entity Type | Individual
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Provider Name | KARLA I MANSILLA MA, MPA, ASW
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Gender | Female
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 2000 SIERRA ROAD
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City | CONCORD
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State | CA
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Zip | 94518
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Country | US
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Telephone | 925-363-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 3136 HACIENDA DR
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City | CONCORD
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State | CA
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Zip | 94519-2240
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Country | US
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Telephone | 516-428-4873
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW85216
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License Number State | CA
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