Healthcare Provider Details

I. General information

NPI: 1447876495
Provider Name (Legal Business Name): ADILENE ARREDONDO M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MICHIGAN AVE
VISTA CA
92084-5424
US

IV. Provider business mailing address

460 N ELM ST
ESCONDIDO CA
92025-3002
US

V. Phone/Fax

Practice location:
  • Phone: 760-639-9519
  • Fax:
Mailing address:
  • Phone: 833-867-4642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: