Individual
AMBAR MARIA CORUGEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3855-F ALAMO STREET, SUITE 2032, SIMI VALLEY, CA 93040
(805) 582-7507
(805) 582-7514
Mailing address
3855-F ALAMO STREET, SUITE 2032, SIMI VALLEY, CA 93040
(805) 582-7507
(805) 582-7514
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCS12610
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCS12610
LCSW
CA
Enumeration date
05/09/2007
Last updated
07/08/2007
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