Individual provider · Type 1 NPI

Blake James Coronado

Mental Health Counselor · Stockton, CA

NPI number 1194482703 Active

Practice location

2495 W March Ln
Stockton, CA 95207-8251

Specialties and licenses

TaxonomyCodeLicense
Marriage & Family Therapist 106H00000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed
Social Worker 104100000XNone listed

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About NPI 1194482703

Blake James Coronado's National Provider Identifier is 1194482703, issued on Nov 18, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Stockton, CA. The record was last updated on Nov 18, 2021.