Healthcare Provider Details

I. General information

NPI: 1689171456
Provider Name (Legal Business Name): LERAE ARIAGNO LMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 EXECUTIVE WAY STE 200
REDDING CA
96002-0635
US

IV. Provider business mailing address

PO BOX 950
RED BLUFF CA
96080-0950
US

V. Phone/Fax

Practice location:
  • Phone: 530-722-1022
  • Fax:
Mailing address:
  • Phone: 530-722-1022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number128008
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: