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Individual

ENRIQUE CARRANZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. A.

Contact information

Practice address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-5452
(541) 296-5263
Mailing address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(412) 965-4525
(541) 296-5263

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19-QMHPC-00686
OR
101YM0800X
Mental Health Counselor
IMF96134
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7184
MEDI-CAL
CA
01
7368
MEDI-CAL
CA
01
7667
MEDI-CAL
CA
01
7708
MEDI-CAL
CA
Enumeration date
12/12/2016
Last updated
11/21/2024
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