Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | ||
N | 225400000X | Rehabilitation Practitioner |
NPI | 1033300652 |
---|---|
Provider Name | Carolina Corona Santana |
First Address | Los Angeles, CA 90017-1466 |
Second Address | Los Angeles, CA 90017-1466 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 05/10/2021 |