Healthcare Provider Details

I. General information

NPI: 1629737523
Provider Name (Legal Business Name): MIRIAM JANAY ARCINIEGA ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2021
Last Update Date: 04/05/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16756 CHINO CORONA RD
CORONA CA
92880-9508
US

IV. Provider business mailing address

16756 CHINO CORONA RD
CORONA CA
92880-9508
US

V. Phone/Fax

Practice location:
  • Phone: 909-597-1771
  • Fax:
Mailing address:
  • Phone: 909-597-1771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: