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General NPI Number Information
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NPI Number | 1134001696
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Entity Type | Individual
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Provider Name | KARINA MICHELENA
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Gender | Female
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 31739 RIVERSIDE DR STE A1
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-7818
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Country | US
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Telephone | 951-245-0050
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Fax | 951-245-0999
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Provider Business Mailing Address
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Address Line | 10376 SPARKLING DR UNIT 2
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0328
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Country | US
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Telephone | 909-767-7884
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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