Individual provider · NPI-1

Marilyn Yandira Corrales

Student in an Organized Health Care Education/Training Program · Loma Linda, CA

NPI number1750159562
StatusActive
Last updated in NPPESApr 23, 2024

Details

NPI
1750159562
Entity type
Individual (NPI-1)
Name
Marilyn Yandira Corrales
Sex
Female
Sole proprietor
No
Enumeration date
Dec 12, 2023
Certification date
Apr 23, 2024
Last updated
Apr 23, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes
172V00000X Community Health Worker––

Practice location

11234 Anderson Street
Gme Office Westerly Suite C
Loma Linda, CA 92354-2804

Phone 909-588-4354

Mailing address

11234 Anderson Street
Gme Office Westerly Suite C
Loma Linda, CA 92354-2804

Phone 909-588-4354

Other practice locations

768 N Mount Vernon Ave
San Bernardino, CA 92411-2755

Phone 909-649-2295

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