Provider Demographics
NPI:1902056849
Name:CARABAJAL, JOE
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:
Last Name:CARABAJAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 W RAY RD
Mailing Address - Street 2:STE 2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3516
Mailing Address - Country:US
Mailing Address - Phone:480-726-2600
Mailing Address - Fax:480-726-2200
Practice Address - Street 1:2340 W RAY RD
Practice Address - Street 2:STE 2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3516
Practice Address - Country:US
Practice Address - Phone:480-726-2600
Practice Address - Fax:480-726-2200
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1868103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical