Basic Information
Provider Information
NPI: 1699351114
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIALON
FirstName: APRILL
MiddleName: EVEONE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 58471 29 PALMS HWY STE 102
Address2:  
City: YUCCA VALLEY
State: CA
PostalCode: 922845818
CountryCode: US
TelephoneNumber: 7608534888
FaxNumber: 7604182201
Practice Location
Address1: 7281 DUMOSA AVE STE 4
Address2:  
City: YUCCA VALLEY
State: CA
PostalCode: 922843781
CountryCode: US
TelephoneNumber: 7608534755
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2021
LastUpdateDate: 03/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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