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General NPI Number Information
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NPI Number | 1962923383
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Entity Type | Individual
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Provider Name | MS. CORAL T VELARDE-THORNE
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Gender | Female
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 359 GABILAN DR
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City | SOLEDAD
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State | CA
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Zip | 93960-3550
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Country | US
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Telephone | 831-678-5136
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Fax |
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Provider Business Mailing Address
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Address Line | 2 13TH ST
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City | GREENFIELD
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State | CA
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Zip | 93927-4616
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Country | US
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Telephone |
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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 | E2417745
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License Number State | CA
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