Provider Demographics
NPI:1316750953
Name:ARNOLD, ELICIA LANEAL (MSW)
Entity type:Individual
Prefix:MRS
First Name:ELICIA
Middle Name:LANEAL
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12254 CHICORY CT
Mailing Address - Street 2:
Mailing Address - City:ETIWANDA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-9033
Mailing Address - Country:US
Mailing Address - Phone:626-345-8054
Mailing Address - Fax:
Practice Address - Street 1:1481 WINDSOR DR
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-5416
Practice Address - Country:US
Practice Address - Phone:909-361-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty