Healthcare Provider Details

I. General information

NPI: 1801708474
Provider Name (Legal Business Name): MICHELLE FRIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12526 PALM DR
DESERT HOT SPRINGS CA
92240-4574
US

IV. Provider business mailing address

87200 AIRPORT BLVD
THERMAL CA
92274-2400
US

V. Phone/Fax

Practice location:
  • Phone: 951-440-6220
  • Fax: 951-244-5542
Mailing address:
  • Phone: 951-440-6220
  • Fax: 951-244-5542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: