Provider Information for 1811497027
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BEVERLY DENISE CORONA LCSW
Sex: Female
NPI: 1811497027
Last Updated: 2024-08-21
Certification Date: 2024-08-21
Certification Date: 2024-08-21
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1811497027 | ||||||||||||
| Enumeration Date | 2018-02-14 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 567 CATHEDRAL CITY, CA 92235-0567 United States Phone: 310-993-7943 | Fax: | ||||||||||||
| Primary Practice Address | 2501 HARBOR BLVD COSTA MESA, CA 92626-6143 United States Phone: 714-587-4701 | Fax: | ||||||||||||
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