Healthcare Provider Details

I. General information

NPI: 1497194898
Provider Name (Legal Business Name): LUCIA CORONEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17800 US HIGHWAY 18
APPLE VALLEY CA
92307-1221
US

IV. Provider business mailing address

7615 ETIWANDA AVE UNIT 274
RANCHO CUCAMONGA CA
91739-7010
US

V. Phone/Fax

Practice location:
  • Phone: 760-242-6336
  • Fax:
Mailing address:
  • Phone: 951-254-3641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number82511
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number35571
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: