Healthcare Provider Details

I. General information

NPI: 1538907167
Provider Name (Legal Business Name): ARIANNA DEL REAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 HOWARD RD STE 125
MADERA CA
93637-5155
US

IV. Provider business mailing address

1930 HOWARD RD STE 125
MADERA CA
93637-5155
US

V. Phone/Fax

Practice location:
  • Phone: 559-675-0105
  • Fax:
Mailing address:
  • Phone: 559-675-0105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberSUDRC-18616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: