Provider Demographics
NPI:1043497282
Name:ALDANA, ANA ELENA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ELENA
Last Name:ALDANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:ELENA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10200 SEPULVEDA BLVD.
Mailing Address - Street 2:UNIT 100
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345
Mailing Address - Country:US
Mailing Address - Phone:818-745-2515
Mailing Address - Fax:818-691-2377
Practice Address - Street 1:10200 SEPULVEDA BLVD.
Practice Address - Street 2:UNIT 100
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345
Practice Address - Country:US
Practice Address - Phone:818-745-2515
Practice Address - Fax:818-691-2377
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF61856101YM0800X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7368OtherMEDICAL
CA7667OtherMEDICAL
CA7708OtherMEDICAL
CA7184OtherMEDICAL