Healthcare Provider Details

I. General information

NPI: 1174841159
Provider Name (Legal Business Name): MARIA GUADALUPE ARREDONDO-CORONEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 GREAT AMERICA PKWY STE 320
SANTA CLARA CA
95054-1140
US

IV. Provider business mailing address

1043 PASEO DEL OCASO
CALEXICO CA
92231-4517
US

V. Phone/Fax

Practice location:
  • Phone: 323-205-7088
  • Fax:
Mailing address:
  • Phone: 760-679-4992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158506
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: