Provider Demographics
NPI:1790386167
Name:OVIEDO, CHIRLEY
Entity Type:Individual
Prefix:
First Name:CHIRLEY
Middle Name:
Last Name:OVIEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 S VICENTIA AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2157
Mailing Address - Country:US
Mailing Address - Phone:951-407-6710
Mailing Address - Fax:
Practice Address - Street 1:285 S VICENTIA AVE APT 3
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2157
Practice Address - Country:US
Practice Address - Phone:951-407-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician