Provider Demographics
NPI:1104682376
Name:DEL REAL, NAYELI I (MFT)
Entity type:Individual
Prefix:
First Name:NAYELI
Middle Name:I
Last Name:DEL REAL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81117 FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-2802
Mailing Address - Country:US
Mailing Address - Phone:442-279-2335
Mailing Address - Fax:
Practice Address - Street 1:77564 COUNTRY CLUB DR STE 201
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-0449
Practice Address - Country:US
Practice Address - Phone:760-702-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141682106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist