MEDICARE: SARA MICHELE CARRANZA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1073227633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA MICHELE CARRANZA

Provider Business Mailing Address
First Line	:	1374 E HILLCREST DR APT 310
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-2520
Country	:	US
Telephone Number	:	805-907-8430
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 N VENTURA RD
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93030-3855
Country	:	US
Telephone Number	:	714-202-0666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	01/09/2023

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Directions to “ SARA MICHELE CARRANZA ” Practice Location

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