Provider Demographics
NPI:1467323352
Name:MANDUJANO, CAROLINA (PPS CREDENTIAL)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:MANDUJANO
Suffix:
Gender:F
Credentials:PPS CREDENTIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 LARKIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-1970
Mailing Address - Country:US
Mailing Address - Phone:831-784-5424
Mailing Address - Fax:831-783-3050
Practice Address - Street 1:645 LARKIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-1970
Practice Address - Country:US
Practice Address - Phone:831-784-5424
Practice Address - Fax:831-783-3050
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool