Individual
CORINE ULLOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
34764 BIRCH RD, BARSTOW, CA 92311-7237
(760) 548-7649
Mailing address
34756 BIRCH RD, BARSTOW, CA 92311-7237
(760) 548-7649
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
C6556567
CA
Other
Enumeration date
12/09/2025
Last updated
12/09/2025
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