Healthcare Provider Details

I. General information

NPI: 1770286825
Provider Name (Legal Business Name): ARIANNE FELICITAS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S VERMONT AVE # 90026
LOS ANGELES CA
90020-1912
US

IV. Provider business mailing address

510 S VERMONT AVE # 90026
LOS ANGELES CA
90020-1912
US

V. Phone/Fax

Practice location:
  • Phone: 424-429-6184
  • Fax:
Mailing address:
  • Phone: 424-429-6184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A25136
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: