Most Relevant Information
Provider Data
| NPI Number: | 1003635129 |
| Provider Name: | KELLY ANN CARONNA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/07/2024 |
| Last Updated: | 10/07/2024 |
Provider Practice Location
16782 VON KARMAN AVE STE 11
IRVINE
CA
926062417
Practice Location Phone/Fax
| Phone: | 6195506368 |
| Fax: |
Provider Mailing Location
PO BOX 33568
SAN DIEGO
CA
921633568
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |