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1101 California Ave Ste 100 Corona CA 92881-6472 | |
| (714) 584-9700 | |
| (714) 584-9700 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1101 California Ave Ste 100, Corona, California |
| Authorized Official Name and Position | Rachael L Morua (OWNER) |
| Authorized Official Contact | 7145849700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1101 California Ave Ste 100 Corona CA 92881-6472 Ph: (714) 584-9700 | 1101 California Ave Ste 100 Corona CA 92881-6472 Ph: (714) 584-9700 |
| NPI Number | 1124656194 |
|---|---|
| Provider Enumeration Date | 03/27/2020 |
| Last Update Date | 06/19/2024 |
| Certification Date | 06/19/2024 |
| Medicare PECOS PAC ID | 8123563491 |
|---|---|
| Medicare Enrollment ID | O20240710004417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124656194 | NPI | - | NPPES |
| Provider Name | Rachael L Morua |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1124594106 PECOS PAC ID: 9032654306 Enrollment ID: I20240710004603 |
| Provider Name | Elaine Helen Stahlhofen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1932301348 PECOS PAC ID: 0749725901 Enrollment ID: I20240711002582 |
| Provider Name | Frederick L Smoot |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982792057 PECOS PAC ID: 0749725919 Enrollment ID: I20240711003089 |
| Provider Name | Lysette Nana Etti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992990519 PECOS PAC ID: 3072058908 Enrollment ID: I20240715003555 |
| Provider Name | Marisa Angelica Sanchez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306181458 PECOS PAC ID: 7618414491 Enrollment ID: I20240730002734 |
| Provider Name | Carla Naragon |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1073731675 PECOS PAC ID: 6901343557 Enrollment ID: I20240801000833 |
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