Individual provider Active NPI

Blanca Estella Corrales

  • Mental Health Counselor
  • Watsonville, CA
National Provider Identifier
1730305368
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
245 E Lake Ave
Watsonville, CA 95076-4717
Phone
(831) 688-5300
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

245 E Lake Ave
Watsonville, CA 95076-4717

Mailing address

241 E Lake Ave
Watsonville, CA 95076-4717

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ920692OtherCAMEDI-CAL
ZZZ91892ZOtherSANTA CRUZ MEDICARE GROUP PTAN#

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1730305368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 E LAKE AVE",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E LAKE AVE",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764717",
            "telephone_number": "831-688-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRALES",
        "first_name": "BLANCA",
        "middle_name": "ESTELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "ZZZ920692",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91892Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.