Provider Demographics
NPI:1861737132
Name:CORONA, DANIELLE (MA, BCBA)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:CORONA
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13051 RATNER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-1024
Mailing Address - Country:US
Mailing Address - Phone:818-426-0857
Mailing Address - Fax:
Practice Address - Street 1:13051 RATNER ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-1024
Practice Address - Country:US
Practice Address - Phone:818-426-0857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11211851251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health