Healthcare Provider Details

I. General information

NPI: 1114394806
Provider Name (Legal Business Name): NKOLIKA AREH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2015
Last Update Date: 04/23/2022
Certification Date: 04/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26520 CACTUS AVE
MORENO VALLEY CA
92555-3927
US

IV. Provider business mailing address

2371 SAN PEDRO AVE
HEMET CA
92545-2434
US

V. Phone/Fax

Practice location:
  • Phone: 951-259-5238
  • Fax:
Mailing address:
  • Phone: 951-259-5238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number84214
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: