Healthcare Provider Details

I. General information

NPI: 1154247179
Provider Name (Legal Business Name): PRISCILLA MAE FIELDS 101YP1600X
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 W MAIN ST STE G
BARSTOW CA
92311-2670
US

IV. Provider business mailing address

1041 W MAIN ST STE G
BARSTOW CA
92311-2670
US

V. Phone/Fax

Practice location:
  • Phone: 760-957-7745
  • Fax: 760-818-4025
Mailing address:
  • Phone: 760-957-7745
  • Fax: 760-818-4025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: