Healthcare Provider Details

I. General information

NPI: 1871141564
Provider Name (Legal Business Name): ADRYAHNA CHEYANNE PACE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADRYAHNA CHEYANNE-PACE AFEANEKU LCSW

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28865 PUJOL ST APT 1616
TEMECULA CA
92590-6729
US

IV. Provider business mailing address

6840 BEAR RIVER ROW UNIT 3
SAN DIEGO CA
92139-2729
US

V. Phone/Fax

Practice location:
  • Phone: 619-818-9088
  • Fax:
Mailing address:
  • Phone: 619-818-9088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number132427
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number112111
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: