Provider Demographics
NPI:1073072336
Name:ARIAS, PAMELA DE JESUS
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:DE JESUS
Last Name:ARIAS
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 1:44300 LOWTREE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4171
Mailing Address - Country:US
Mailing Address - Phone:661-418-5093
Mailing Address - Fax:
Practice Address - Street 1:44300 LOWTREE AVE STE 106
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4171
Practice Address - Country:US
Practice Address - Phone:661-418-5093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-17
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator