Healthcare Provider Details

I. General information

NPI: 1295409639
Provider Name (Legal Business Name): ASTRID GUADALUPE FEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2021
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46883 MONROE ST
INDIO CA
92201-6768
US

IV. Provider business mailing address

3775 COUGAR CANYON RD
HEMET CA
92545-9022
US

V. Phone/Fax

Practice location:
  • Phone: 760-398-9090
  • Fax:
Mailing address:
  • Phone: 951-658-9354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC9719
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: