Provider Demographics
NPI:1730293341
Name:CORTES, DARA LAUREN (PPSC, BA, MSW)
Entity Type:Individual
Prefix:MRS
First Name:DARA
Middle Name:LAUREN
Last Name:CORTES
Suffix:
Gender:F
Credentials:PPSC, BA, MSW
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:LAUREN
Other - Last Name:CHEIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5672 KERN DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2099 STATE COLLEGE BLVD
Practice Address - Street 2:#250
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805
Practice Address - Country:US
Practice Address - Phone:714-450-4168
Practice Address - Fax:714-978-3419
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA180851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical