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General NPI Number Information
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NPI Number | 1063041341
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Entity Type | Individual
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Provider Name | BRIANNA ELIA COQUE MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 1801 PARK COURT PL BLDG H
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City | SANTA ANA
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State | CA
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Zip | 92701-5028
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Country | US
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Telephone | 510-317-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 233 S QUINTANA DR
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City | ANAHEIM
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State | CA
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Zip | 92807-4029
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Country | US
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Telephone | 714-881-8600
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 109838
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 130133
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License Number State | CA
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