Provider Demographics
NPI:1851034227
Name:CORONADO, RAMON (LCSW)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:CORONADO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20652 BUCKLAND DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1107
Mailing Address - Country:US
Mailing Address - Phone:909-598-0675
Mailing Address - Fax:
Practice Address - Street 1:20652 BUCKLAND DR
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-1107
Practice Address - Country:US
Practice Address - Phone:909-598-0675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA870531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical