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General NPI Number Information
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NPI Number | 1598659450
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Entity Type | Individual
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Provider Name | UMI CAITLIN CORONEL MANGUNE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 2182 EAST ST
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City | CONCORD
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State | CA
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Zip | 94520-2012
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Country | US
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Telephone | 925-685-4224
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Fax |
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Provider Business Mailing Address
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Address Line | 72 DEL PRADO CIR
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City | FAIRFIELD
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State | CA
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Zip | 94533-1868
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Country | US
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Telephone | 707-803-4805
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95034708
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License Number State | CA
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