Individual provider Active NPI

Yvette Lucina Coronado, LCSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1285983791
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
77651 Issued in CA
Practice address
1245 E Santa Clara St
San Jose, CA 95116-2337
Phone
(408) 564-1038
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 77651 CA Primary

Addresses

Primary practice location

1245 E Santa Clara St
San Jose, CA 95116-2337

Mailing address

1245 E Santa Clara St
San Jose, CA 95116-2337
Phone (408) 564-1038

Other practice location 1

160 E Virginia St Ste 280
San Jose, CA 95112-5817
Phone (408) 287-6200

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

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1285983791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 E SANTA CLARA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951162337",
            "telephone_number": "408-564-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 E SANTA CLARA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951162337",
            "telephone_number": "408-564-1038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 E Virginia St Ste 280",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951125817",
            "country_code": "US",
            "telephone_number": "408-287-6200",
            "fax_number": "408-998-1535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "YVETTE",
        "middle_name": "LUCINA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "77651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.