Provider Demographics
NPI:1871966283
Name:CARBAJAL, OSCAR ARMANDO (AMFT)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:ARMANDO
Last Name:CARBAJAL
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6509 LARRY WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-4011
Mailing Address - Country:US
Mailing Address - Phone:707-889-6374
Mailing Address - Fax:
Practice Address - Street 1:2829 WATT AVE STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6245
Practice Address - Country:US
Practice Address - Phone:916-418-0828
Practice Address - Fax:916-418-0838
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA89518106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program