Provider Demographics
NPI:1225836646
Name:CORONEL, ALEJANDRO DARIO
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:DARIO
Last Name:CORONEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 STEFFA ST
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6769
Mailing Address - Country:US
Mailing Address - Phone:925-642-1189
Mailing Address - Fax:
Practice Address - Street 1:1449 YGNACIO VALLEY RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2932
Practice Address - Country:US
Practice Address - Phone:925-939-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant