Healthcare Provider Details

I. General information

NPI: 1104754043
Provider Name (Legal Business Name): MRS. ADRIANNA CHEVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E RINCON ST STE 203
CORONA CA
92879-1363
US

IV. Provider business mailing address

38596 VIA VISTA GRANDE
MURRIETA CA
92562-7175
US

V. Phone/Fax

Practice location:
  • Phone: 951-445-2615
  • Fax:
Mailing address:
  • Phone: 951-445-2615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-28862
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: