Provider Demographics
NPI:1235601980
Name:CAMARENA, YOSELINE KARINA
Entity Type:Individual
Prefix:
First Name:YOSELINE
Middle Name:KARINA
Last Name:CAMARENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2596 AVENIDA DEL VIS # G203
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-6216
Mailing Address - Country:US
Mailing Address - Phone:626-660-9474
Mailing Address - Fax:
Practice Address - Street 1:23824 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5935
Practice Address - Country:US
Practice Address - Phone:310-791-3064
Practice Address - Fax:310-791-3084
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225400000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner