CORALIE WEGNER (NPI# 1306494950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306494950 |
| Entity Type | Individual |
| Full Name | CORALIE WEGNER |
| Credential | LEP 2804 |
| Practice Address |
6960 Destiny Dr Ste 112 Rocklin CA 95677-2995 |
| Practice Telephone | 9162960564 |
| Mailing Telephone | 9162960564 |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
2804 | CA | Behavioral Health & Social Service Providers |
| Street Address |
6960 DESTINY DR STE 112 |
| City | ROCKLIN |
| State | CA |
| Zip Code | 95677-2995 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629408695 | Alyson Gini | Behavioral Analyst | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2013-11-12 |
| 1356998876 | Samantha Zavala | Physical Therapist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2019-08-20 |
| 1841845914 | Michelle H Nguyen | Occupational Therapist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2019-08-06 |
| 1770140162 | Stacie Marie Chastain | Speech-Language Pathologist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2019-05-22 |
| 1154984045 | Lori Ermshar | Speech-Language Pathologist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2019-04-17 |
| 1306312350 | Michelle Elizabeth O'neill | Speech-Language Pathologist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2018-10-17 |
| 1245757079 | Valerie Ilacqua | Speech-Language Pathologist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2017-08-23 |
| 1952828881 | Shivani Bhakta | Speech-Language Pathologist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2017-08-22 |
| 1710403258 | Carly Rosada | Occupational Therapist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2017-08-16 |
| 1821535741 | Shannon Kelly | Occupational Therapist | 6960 Destiny Dr Ste 112, Rocklin, CA 95677-2995 | 2017-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629564752 | Aimee K. Lubell | Psychologist | 3175 Sunset Blvd., Suite 104b, Rocklin, CA 95677 | 2018-07-01 |
| 1659810760 | Cal Urgent Care, PC | Clinic/Center | 6641 Stanford Ranch Rd, Rocklin, CA 95677 | 2017-02-22 |
| 1821469370 | Gold Country Hearing Associates, Inc | Audiologist-Hearing Aid Fitter | 4780 Granite Drive Suite 600, Rocklin, CA 95677 | 2015-10-09 |
| 1013325778 | Dave Si Dong | Pharmacist | 5609 Pacific Street, Rocklin, CA 95677 | 2014-07-25 |
| 1417235532 | On Demand Primary Care & Nursing, Inc | Nurse Practitioner | 4585 Northstar Street, Rocklin, CA 95677 | 2011-07-22 |
| 1093903312 | John Ewing Kiesselbach | Dentist | 6000 Fairway Drive, Suite 10, Rocklin, CA 95677 | 2007-10-11 |
| 1235322082 | Elizabeth Anne Roullier Bunz | Dentist | 4230 Rocklin Rd, Rocklin, CA 95677 | 2007-08-24 |
| 1366576712 | Michael Alen Laidlaw | Marriage & Family Therapist | 5780 Grove Street, Rocklin, CA 95677 | 2007-03-16 |
| 1033281365 | Sunnie Lee Skiles | Pediatrics | 6815 Five Star Blvd Ste 100, Rocklin, CA 95677 | 2006-11-14 |
| 1164516779 | Kasi L. Franck | Dentist | 3104 Sunset Blvd Ste 1a, Rocklin, CA 95677 | 2006-10-03 |
| Find all providers in zip 95677 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942800610 | Christine Irene Wyeth I | Psychologist | 420 Orrell Dr, National City, CA 91950-7019 | 2020-10-30 |
| 1396351755 | Darinisha Williams | Psychologist | 228 W Pomona Ave Unit 453, Monrovia, CA 91016-4853 | 2020-09-21 |
| 1861006280 | Waneka Cabrera | Psychologist | 6140 Monterey Rd Apt 419, Los Angeles, CA 90042-5410 | 2020-09-02 |
| 1447862669 | Lynn Syrvart Saroyan | Psychologist | 302 W 5th St Ste 301, San Pedro, CA 90731-2750 | 2020-08-19 |
| 1386256741 | Earaj Afzal | Psychologist | 4175 Williwaw Dr, Irvine, CA 92620-3279 | 2020-08-18 |
| 1518578145 | Christina Marie Keefe | Psychologist | 222 Terrace Dr, Big Pine, CA 93513-2002 | 2020-08-17 |
| 1992317572 | Ferris Kevin Bruton | Psychologist | 850 Rosewood Ave, Vallejo, CA 94591-5647 | 2020-08-17 |
| 1376153460 | Louis Scott Addleson | Psychologist | 7915 Alida St, La Mesa, CA 91942-2541 | 2020-08-04 |
| 1326658592 | Aamna Hassan | Psychologist | 15132 Amso St, Poway, CA 92064-2604 | 2020-08-03 |
| 1922616218 | Janis Kingsley | Psychologist | 2746 Granville Ave, Los Angeles, CA 90064-3604 | 2020-07-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.