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General NPI Number Information
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NPI Number | 1598192197
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Entity Type | Individual
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Provider Name | CARLOTTA A DURAZO
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Gender | Female
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Dates
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Enumeration Date | 09/27/2013
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 500 LA TERRAZA BLVD SUITE 130
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City | ESCONDIDO
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State | CA
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Zip | 92025-3875
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Country | US
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Telephone | 760-737-2050
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Fax | 760-796-3785
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Provider Business Mailing Address
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Address Line | 7957 CALLE COZUMEL
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City | CARLSBAD
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State | CA
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Zip | 92009-9318
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Country | US
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Telephone | 760-310-9036
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Fax | 760-796-3785
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS10714
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License Number State | CA
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