Healthcare Provider Details

I. General information

NPI: 1992684898
Provider Name (Legal Business Name): ARIEL AMETHYST FERRARA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13128 PACIFIC RD
PHELAN CA
92371-6742
US

IV. Provider business mailing address

PO BOX 293145
PHELAN CA
92329-3145
US

V. Phone/Fax

Practice location:
  • Phone: 760-686-7524
  • Fax:
Mailing address:
  • Phone: 760-686-7524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95038642
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95305643
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: