Provider Demographics
NPI:1952181281
Name:CORIA, RENE SAMUEL
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:SAMUEL
Last Name:CORIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 S E ST APT 327
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-4727
Mailing Address - Country:US
Mailing Address - Phone:661-955-4332
Mailing Address - Fax:
Practice Address - Street 1:358 S E ST APT 327
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-4727
Practice Address - Country:US
Practice Address - Phone:661-955-4332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171400000XOther Service ProvidersHealth & Wellness Coach
No175T00000XOther Service ProvidersPeer Specialist