Provider Demographics
NPI:1083072581
Name:ARELLANO, MARIELA
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:
Last Name:ARELLANO
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 1:500 W 10TH ST SPC 155
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-6528
Mailing Address - Country:US
Mailing Address - Phone:831-254-3957
Mailing Address - Fax:
Practice Address - Street 1:8352 CHURCH ST
Practice Address - Street 2:SUITE C
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-4449
Practice Address - Country:US
Practice Address - Phone:831-254-3957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health