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NPI Code Detail

MEDICARE: DE'NAYSHA COLEMAN

MEDICARE: DE'NAYSHA COLEMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1164181764
Entity Type Code : Individual
Provider Name (Legal Business Name) : DE'NAYSHA COLEMAN
Provider Business Mailing Address
First Line : 18612 SANTA ANA AVE SPC 3
Second Line :
City : BLOOMINGTON
State : CA
Zip : 92316-2639
Country : US
Telephone Number : 909-421-7120
Fax Number :
Provider Business Practice Location Address
First Line : 10001 COUNTY FARM RD
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-3507
Country : US
Telephone Number : 909-421-7120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2021
Last Update Date : 12/04/2025

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Directions to “ DE'NAYSHA COLEMAN ” Practice Location

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