Individual
DEISY CORNEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW, MSW, ASW
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501
(707) 268-2990
Mailing address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
82931
CA
171M00000X
Case Manager/Care Coordinator
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
07/24/2017
Last updated
07/21/2022
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