Provider Demographics
NPI:1396438933
Name:SUNO, CAROLINA MEYERLIN
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:MEYERLIN
Last Name:SUNO
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 1:828 CALLA AVE APT B
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-1570
Mailing Address - Country:US
Mailing Address - Phone:619-779-2224
Mailing Address - Fax:
Practice Address - Street 1:1625 NEWTON AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-1012
Practice Address - Country:US
Practice Address - Phone:619-779-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health