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General NPI Number Information
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NPI Number | 1962121327
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Entity Type | Individual
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Provider Name | CAROLINA HERRERA
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Gender | Female
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 1802 CALIFORNIA ST
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City | EUREKA
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State | CA
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Zip | 95501-2808
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Country | US
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Telephone | 707-443-7358
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Fax | 707-443-1092
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Provider Business Mailing Address
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Address Line | 1836 PENN AVE
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City | FORTUNA
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State | CA
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Zip | 95540-3725
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Country | US
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Telephone | 707-617-0513
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 12202
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License Number State | CA
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