Coral Montecinos-Wilson

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

170198472 Issued in CA

Practice address

3490 La Sierra Ave Ste F920
Riverside, CA 92503-5214

Phone

(951) 723-5311

NPI assigned

Nov 12, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1265034367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 LA SIERRA AVE STE F920",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035214",
            "telephone_number": "951-723-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 LA SIERRA AVE STE F920",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035214",
            "telephone_number": "951-723-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTECINOS-WILSON",
        "first_name": "CORAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "170198472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "coral.wilson@presencelearning.com",
            "affiliation": "N",
            "address_1": "11261 Cullen Ct",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marissa Bernice Montanez
• Michael Thomas Montanio
• Katheryn Montano-Cortez
• Araceli Josefina Montano
• Lisa K Montano
• Ruben Michael Montejano
• Montelago Congregate Living, LLC
• Johana Montellano
• Maria G Montellano, LCSW
• Veronica Montemagni, RDH

• School Psychologist in Riverside, CA
• Providers in Riverside, CA by specialty
• School Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.