Provider Demographics
NPI:1841966181
Name:CIRIGO, CAROL LEANORE
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:LEANORE
Last Name:CIRIGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24593 MONTEREY AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92410-4902
Mailing Address - Country:US
Mailing Address - Phone:562-366-6223
Mailing Address - Fax:
Practice Address - Street 1:24593 MONTEREY AVE UNIT A
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410-4902
Practice Address - Country:US
Practice Address - Phone:562-366-6223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician