Provider Demographics
NPI:1710610845
Name:ARIAS, ANNETTE AMELIA
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:AMELIA
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 1:34462 THE FARM RD
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-9294
Mailing Address - Country:US
Mailing Address - Phone:951-807-7516
Mailing Address - Fax:
Practice Address - Street 1:34462 THE FARM RD
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-9294
Practice Address - Country:US
Practice Address - Phone:951-807-7516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor