Provider Demographics
NPI:1841787231
Name:OSORNIO, MICHELLA C
Entity type:Individual
Prefix:
First Name:MICHELLA
Middle Name:C
Last Name:OSORNIO
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 1:9567 ARROW RTE STE M
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4550
Mailing Address - Country:US
Mailing Address - Phone:909-774-1137
Mailing Address - Fax:
Practice Address - Street 1:9567 ARROW RTE STE M
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4550
Practice Address - Country:US
Practice Address - Phone:909-774-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator