Provider Demographics
NPI:1326383845
Name:AYALA, ASHLEY (MS)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:AYALA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12818 SOUTHERN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3676
Mailing Address - Country:US
Mailing Address - Phone:925-785-7375
Mailing Address - Fax:
Practice Address - Street 1:12818 SOUTHERN VALLEY DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3676
Practice Address - Country:US
Practice Address - Phone:925-785-7375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96673106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1326383845OtherOPTUM