Provider Demographics
NPI:1174402960
Name:FELICIANO, NEFTALY MAGALLANES (PPS COUNSELING)
Entity type:Individual
Prefix:
First Name:NEFTALY
Middle Name:MAGALLANES
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:PPS COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N CLOVERDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95425-3324
Mailing Address - Country:US
Mailing Address - Phone:707-894-1924
Mailing Address - Fax:
Practice Address - Street 1:509 N CLOVERDALE BLVD
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:CA
Practice Address - Zip Code:95425-3324
Practice Address - Country:US
Practice Address - Phone:707-894-1924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool