Provider Demographics
NPI:1154090736
Name:APARICIO-PHILLIPS, ARIANA (OD)
Entity type:Individual
Prefix:DR
First Name:ARIANA
Middle Name:
Last Name:APARICIO-PHILLIPS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ARIANA
Other - Middle Name:
Other - Last Name:APARICIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:6700 INDIANA AVE STE 155
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4225
Mailing Address - Country:US
Mailing Address - Phone:951-682-1600
Mailing Address - Fax:
Practice Address - Street 1:6700 INDIANA AVE STE 155
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4225
Practice Address - Country:US
Practice Address - Phone:951-682-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34936TLG152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB392537Medicaid