Individual
MS. CAMILLE A.M. FERNANDEZ-CORONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11835 W OLYMPIC BLVD, # 1090, LOS ANGELES, CA 90064-5001
(131) 040-6905
Mailing address
PO BOX 64, HERMOSA BEACH, CA 90254-0064
(131) 040-6905
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS13596
CA
1041S0200X
School Social Worker
LCS13596
CA
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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