Healthcare Provider Details

I. General information

NPI: 1144044504
Provider Name (Legal Business Name): STEVEN MICHAEL AVILA PPS, APCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3576 ARLINGTON AVE STE 203
RIVERSIDE CA
92506-3984
US

IV. Provider business mailing address

3576 ARLINGTON AVE STE 203
RIVERSIDE CA
92506-3984
US

V. Phone/Fax

Practice location:
  • Phone: 951-394-0167
  • Fax:
Mailing address:
  • Phone: 951-394-0167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC16299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: