Provider Demographics
NPI:1114233657
Name:BALVANEDA, ARELI
Entity Type:Individual
Prefix:MRS
First Name:ARELI
Middle Name:
Last Name:BALVANEDA
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 1:10131 SAN GABRIEL AVE
Mailing Address - Street 2:APT. B
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-6066
Mailing Address - Country:US
Mailing Address - Phone:714-269-6236
Mailing Address - Fax:
Practice Address - Street 1:110 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3810
Practice Address - Country:US
Practice Address - Phone:323-869-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-22
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist