Provider Demographics
NPI:1003152232
Name:AYALA, CELINA MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:MARIE
Last Name:AYALA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 PARK MEADOWS DR.
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2558
Mailing Address - Country:US
Mailing Address - Phone:303-346-8828
Mailing Address - Fax:303-346-0407
Practice Address - Street 1:8080 PARK MEADOWS DR.
Practice Address - Street 2:
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2558
Practice Address - Country:US
Practice Address - Phone:720-493-9006
Practice Address - Fax:800-733-9406
Is Sole Proprietor?:No
Enumeration Date:2012-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3465363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical