Healthcare Provider Details

I. General information

NPI: 1578467544
Provider Name (Legal Business Name): ARIANA AVALOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 MAYHEW WAY STE 100
PLEASANT HILL CA
94523-4372
US

IV. Provider business mailing address

1603 96TH AVE
OAKLAND CA
94603-1517
US

V. Phone/Fax

Practice location:
  • Phone: 925-488-9258
  • Fax:
Mailing address:
  • Phone: 510-712-8307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: