Individual
ANDREA CORONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
675 1ST ST, UPPER LAKE, CA 95485-9586
(707) 263-3116
Mailing address
PO BOX 2077, UKIAH, CA 95482-2077
(707) 467-2010
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/05/2019
Last updated
01/05/2019
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