Healthcare Provider Details

I. General information

NPI: 1730293341
Provider Name (Legal Business Name): DARA LAUREN CORTES PPSC, B.A., MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARA LAUREN CHEIFER

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2099 STATE COLLEGE BLVD #250
ANAHEIM CA
92805
US

IV. Provider business mailing address

5672 KERN DRIVE
HUNTINGTON BEACH CA
92649
US

V. Phone/Fax

Practice location:
  • Phone: 714-450-4168
  • Fax: 714-978-3419
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: