Basic Information
| Provider Information | |||||||||
| NPI: | 1295208643 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANCO IBARRA | ||||||||
| FirstName: | KARINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 CENTRAL AVE STE E1 | ||||||||
| Address2: | |||||||||
| City: | LAKE ELSINORE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925302740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9514711426 | ||||||||
| FaxNumber: | 9514711453 | ||||||||
| Practice Location | |||||||||
| Address1: | 525 TECHNOLOGY CT STE 105 | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925072181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516868500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2019 | ||||||||
| LastUpdateDate: | 10/04/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.