Provider Demographics
NPI:1174201479
Name:CARONNA, NATALIA CHRISTINA (AMFT)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:CHRISTINA
Last Name:CARONNA
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 MALABAR WAY
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92314-9212
Mailing Address - Country:US
Mailing Address - Phone:760-413-7891
Mailing Address - Fax:
Practice Address - Street 1:1625 MALABAR WAY
Practice Address - Street 2:
Practice Address - City:BIG BEAR CITY
Practice Address - State:CA
Practice Address - Zip Code:92314-9212
Practice Address - Country:US
Practice Address - Phone:760-413-7891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT137843106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist