Active NPI
Kaitlyn Samara Coronel
- Pharmacist
- Beaumont, CA
National Provider Identifier
1063384121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 91410
- Practice address
- 35228 Funk Way
Beaumont, CA 92223-6279 - Phone
- (909) 631-0906
- NPI assigned
- Sep 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 91410 | CA | Primary |
Addresses
Primary practice location
35228 Funk Way
Beaumont, CA 92223-6279
Mailing address
35228 Funk Way
Beaumont, CA 92223-6279
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91410 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1063384121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35228 FUNK WAY",
"city": "BEAUMONT",
"state": "CA",
"postal_code": "922236279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35228 FUNK WAY",
"city": "BEAUMONT",
"state": "CA",
"postal_code": "922236279",
"telephone_number": "909-631-0906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORONEL",
"first_name": "KAITLYN",
"middle_name": "SAMARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-18",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "91410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.