Provider Demographics
NPI:1023172335
Name:NUNEZ, ANTONIO CARRASCO (ANTONIO NUNEZ LCSW)
Entity type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:CARRASCO
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:ANTONIO NUNEZ LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 ARROYO CIR
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-7303
Mailing Address - Country:US
Mailing Address - Phone:408-848-7016
Mailing Address - Fax:
Practice Address - Street 1:7520 ARROYO CIR
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7303
Practice Address - Country:US
Practice Address - Phone:408-848-7016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 152671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical