Healthcare Provider Details

I. General information

NPI: 1235057068
Provider Name (Legal Business Name): TRINA ACEVEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30585 MIRASOL DR
REDLANDS CA
92373-7462
US

IV. Provider business mailing address

30585 MIRASOL DR
REDLANDS CA
92373-7462
US

V. Phone/Fax

Practice location:
  • Phone: 951-236-7846
  • Fax:
Mailing address:
  • Phone: 951-236-7846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: