Provider Demographics
NPI:1386152445
Name:NIEVES, ARIANA FELICITAS
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:FELICITAS
Last Name:NIEVES
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 1:1738 S TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5309
Mailing Address - Country:US
Mailing Address - Phone:760-439-2800
Mailing Address - Fax:760-433-5031
Practice Address - Street 1:1738 S TREMONT ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5309
Practice Address - Country:US
Practice Address - Phone:760-439-2800
Practice Address - Fax:760-433-5031
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2021-05-03
Deactivation Date:2021-02-23
Deactivation Code:
Reactivation Date:2021-04-28
Provider Licenses
StateLicense IDTaxonomies
CAF7410470101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty