Sandra Suzanna Cornejo

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CALPU1-224-101111S Issued in CA

Practice address

68625 Perez Rd Ste 11a
Cathedral City, CA 92234-7250

Phone

(760) 773-6767

Fax

(760) 773-6760

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1316069180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68625 PEREZ RD STE 11A",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922347250",
            "telephone_number": "760-773-6767",
            "fax_number": "760-773-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68625 PEREZ RD STE 11A",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922347250",
            "telephone_number": "760-773-6767",
            "fax_number": "760-773-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEJO",
        "first_name": "SANDRA",
        "middle_name": "SUZANNA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CALPU1-224-101111S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Prescription Center
• Compass Health Systems of California Inc
• Bramlett Allen Conley, MFT
• Kimberly Coppage
• Raul Ernesto Cornejo, ACSW 138733
• County of Riverside
• County of Riverside
• County of Riverside
• County of Riverside
• Janice Olympia Cramer

• Addiction (Substance Use Disorder) Counselor in Cathedral City, CA
• Providers in Cathedral City, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.