Provider Demographics
NPI:1497183859
Name:AYALA-GARCIA, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:AYALA-GARCIA
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:CARR 167 RAMAL 829 KM 13.1
Mailing Address - Street 2:BO. SABANA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-9675
Mailing Address - Country:US
Mailing Address - Phone:787-385-3088
Mailing Address - Fax:
Practice Address - Street 1:CARR 167 RAMAL 829 KM 13.1
Practice Address - Street 2:BO. SABANA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-9675
Practice Address - Country:US
Practice Address - Phone:787-385-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR115161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical