Provider Demographics
NPI:1477136414
Name:CORONA, ANALILLIA LEE
Entity Type:Individual
Prefix:MS
First Name:ANALILLIA
Middle Name:LEE
Last Name:CORONA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANA
Other - Middle Name:LEE
Other - Last Name:CORONA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:21600 OXNARD ST STE 1800
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7807
Mailing Address - Country:US
Mailing Address - Phone:818-345-2345
Mailing Address - Fax:
Practice Address - Street 1:1708 COIT RD STE 150
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6198
Practice Address - Country:US
Practice Address - Phone:469-825-4657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician