Provider Demographics
NPI:1760575799
Name:GILLETT, CORINA MARIA (LICENSED CLINICAL SO)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:MARIA
Last Name:GILLETT
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:CORINA
Other - Middle Name:MARIA
Other - Last Name:GILLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICENSED CLINICAL SO
Mailing Address - Street 1:775 FLEISCHMANN WAY BHS OUTPATIENT
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703
Mailing Address - Country:US
Mailing Address - Phone:775-445-7756
Mailing Address - Fax:775-841-0304
Practice Address - Street 1:4875 BROADWAY STE 125
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1500
Practice Address - Country:US
Practice Address - Phone:916-874-3661
Practice Address - Fax:916-875-1190
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 137411041C0700X
CALCSW244461041C0700X
NV7809-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical