Provider Demographics
NPI:1619411154
Name:ENOS, CORINNE (MSW)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:ENOS
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 1:13602 CHARLOMA DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-4503
Mailing Address - Country:US
Mailing Address - Phone:949-633-6921
Mailing Address - Fax:
Practice Address - Street 1:9451 INDIANAPOLIS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-5955
Practice Address - Country:US
Practice Address - Phone:714-593-9630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical