Provider Demographics
NPI:1871153676
Name:VISTA, ARIANA N (OTA)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:N
Last Name:VISTA
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:ARIANA
Other - Middle Name:N
Other - Last Name:KENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9518 9TH ST STE C-1
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4568
Mailing Address - Country:US
Mailing Address - Phone:909-443-9919
Mailing Address - Fax:
Practice Address - Street 1:37111 PALA TEMECULA ROAD
Practice Address - Street 2:
Practice Address - City:PALA
Practice Address - State:CA
Practice Address - Zip Code:92059-2427
Practice Address - Country:US
Practice Address - Phone:858-361-9544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant