Active NPI
Clarissa Corona, CC
- Behavior Technician
- Los Angeles, CA
National Provider Identifier
1811630155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- F4448718
- Practice address
- 4401 Crenshaw Blvd Ste 215
Los Angeles, CA 90043-1200 - Phone
- (323) 291-7100
- NPI assigned
- Apr 14, 2022
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | F4448718 | CA | Primary |
Addresses
Primary practice location
4401 Crenshaw Blvd Ste 215
Los Angeles, CA 90043-1200
Mailing address
4401 Crenshaw Blvd Ste 215
Los Angeles, CA 90043-1200
Phone (323) 291-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106S00000X | Other | OTHER MEDICAL PROFESSION |
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 |
|---|---|---|---|
| F4448718 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1811630155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 CRENSHAW BLVD STE 215",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900431200",
"telephone_number": "323-291-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 CRENSHAW BLVD STE 215",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900431200",
"telephone_number": "323-291-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORONA",
"first_name": "CLARISSA",
"credential": "CC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-14",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "F4448718",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER MEDICAL PROFESSION",
"identifier": "106S00000X",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.