Basic Information
| Provider Information | |||||||||
| NPI: | 1710490925 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARIAT | ||||||||
| FirstName: | VIVIAN | ||||||||
| MiddleName: | CAROLINA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4309 WOODLAND AVE. | ||||||||
| Address2: | |||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8182161426 | ||||||||
| FaxNumber: | 8185632714 | ||||||||
| Practice Location | |||||||||
| Address1: | 2499 S. WILMINGTON AVE. | ||||||||
| Address2: | |||||||||
| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106381113 | ||||||||
| FaxNumber: | 3106388042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2017 | ||||||||
| LastUpdateDate: | 11/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171R00000X | Y | Other Service Providers | Interpreter |
No ID Information.