Provider Demographics
NPI:1073224861
Name:AUGUSTA, CORENA MARIE MAWYER (ICCE, CLE)
Entity Type:Individual
Prefix:MRS
First Name:CORENA
Middle Name:MARIE MAWYER
Last Name:AUGUSTA
Suffix:
Gender:F
Credentials:ICCE, CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9427 FIRE KING CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-4606
Mailing Address - Country:US
Mailing Address - Phone:916-308-8290
Mailing Address - Fax:
Practice Address - Street 1:9427 FIRE KING CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-4606
Practice Address - Country:US
Practice Address - Phone:916-308-8290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula