Provider Demographics
NPI:1164287900
Name:AVILA, ARIANNA FAITH
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:FAITH
Last Name:AVILA
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 1:1855 W OLIVE AVE APT 314
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-5413
Mailing Address - Country:US
Mailing Address - Phone:760-336-6050
Mailing Address - Fax:
Practice Address - Street 1:1855 W OLIVE AVE APT 314
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-5413
Practice Address - Country:US
Practice Address - Phone:760-336-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator