Healthcare Provider Details

I. General information

NPI: 1174431498
Provider Name (Legal Business Name): ALEXIS ARREOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20241 SW BIRCH ST
NEWPORT BEACH CA
92660-1782
US

IV. Provider business mailing address

2034 E LINCOLN AVE # 212
ANAHEIM CA
92806-4101
US

V. Phone/Fax

Practice location:
  • Phone: 949-955-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT141629
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: