Provider Demographics
NPI:1922302702
Name:CORONEL, MARIA DE JESUS
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DE JESUS
Last Name:CORONEL
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 1:9261 FOLSOM BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2560
Mailing Address - Country:US
Mailing Address - Phone:916-369-7872
Mailing Address - Fax:
Practice Address - Street 1:9261 FOLSOM BLVD., STE 500
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826
Practice Address - Country:US
Practice Address - Phone:916-369-7872
Practice Address - Fax:916-363-1638
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator