Basic Information
Provider Information
NPI: 1699845735
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAPARROS
FirstName: EMMA
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10605 BALBOA BLVD
Address2: SUITE 100
City: GRANADA HILLS
State: CA
PostalCode: 913446342
CountryCode: US
TelephoneNumber: 8188322400
FaxNumber:  
Practice Location
Address1: 10605 BALBOA BLVD
Address2: SUITE 100
City: GRANADA HILLS
State: CA
PostalCode: 913446342
CountryCode: US
TelephoneNumber: 8188322400
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/08/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X3900CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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