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General NPI Number Information
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NPI Number | 1023134780
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Entity Type | Individual
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Provider Name | MR. STEVEN D KOROSEC
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11716 ENTERPRISE DR
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City | AUBURN
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State | CA
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Zip | 95603-3732
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Country | US
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Telephone | 530-889-7674
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Fax | 530-889-6891
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Provider Business Mailing Address
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Address Line | 301 PINEWOOD WAY
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City | MEADOW VISTA
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State | CA
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Zip | 95722-9563
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Country | US
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Telephone | 530-878-1017
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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