Healthcare Provider Details

I. General information

NPI: 1598442386
Provider Name (Legal Business Name): YATTZARETH G CORONA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 PROFESSIONAL DR STE B
SACRAMENTO CA
95825-2165
US

IV. Provider business mailing address

8294 CRAIN DR
ROSEMEAD CA
91770-4037
US

V. Phone/Fax

Practice location:
  • Phone: 916-236-3131
  • Fax:
Mailing address:
  • Phone: 626-551-6786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number109808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: