Provider Demographics
NPI:1861894735
Name:ACEVES, ANIKA
Entity type:Individual
Prefix:
First Name:ANIKA
Middle Name:
Last Name:ACEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 TENNESSEE ST STE Y
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-8159
Mailing Address - Country:US
Mailing Address - Phone:760-267-4080
Mailing Address - Fax:
Practice Address - Street 1:414 TENNESSEE ST STE Y
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8159
Practice Address - Country:US
Practice Address - Phone:760-267-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor