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General NPI Number Information
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NPI Number | 1285978593
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Entity Type | Individual
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Provider Name | MRS. INGRID H CORRALES
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Gender | Female
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Dates
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Enumeration Date | 11/27/2012
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 265 S RANDOLPH AVE STE 240
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City | BREA
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State | CA
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Zip | 92821-5783
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Country | US
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Telephone | 714-869-7501
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Fax |
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Provider Business Mailing Address
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Address Line | 8520 MICHIGAN AVE UNIT 4862
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City | WHITTIER
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State | CA
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Zip | 90607-7146
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Country | US
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Telephone | 714-869-7501
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 146296
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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