Provider Demographics
NPI:1407624992
Name:CORONADO, MIREYA ANAID (MSW)
Entity Type:Individual
Prefix:MISS
First Name:MIREYA
Middle Name:ANAID
Last Name:CORONADO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 731686
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95173-1686
Mailing Address - Country:US
Mailing Address - Phone:669-799-6575
Mailing Address - Fax:
Practice Address - Street 1:1285 ESCUELA PKWY
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-3297
Practice Address - Country:US
Practice Address - Phone:408-635-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool