Provider Demographics
NPI:1679389142
Name:STRA, CARMEN ANNA
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:ANNA
Last Name:STRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971-9375
Mailing Address - Country:US
Mailing Address - Phone:707-599-6473
Mailing Address - Fax:530-231-0265
Practice Address - Street 1:702-130 RICHMOND RD E
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-5029
Practice Address - Country:US
Practice Address - Phone:530-283-3330
Practice Address - Fax:530-231-0265
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker