Provider Demographics
NPI:1023360518
Name:TRAYNOR, ARIADNA JIMENEZ
Entity type:Individual
Prefix:
First Name:ARIADNA
Middle Name:JIMENEZ
Last Name:TRAYNOR
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 1:2050 N TUSTIN ST # 1039
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-3902
Mailing Address - Country:US
Mailing Address - Phone:714-557-5419
Mailing Address - Fax:714-577-5450
Practice Address - Street 1:120 S STATE COLLEGE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5837
Practice Address - Country:US
Practice Address - Phone:174-577-5400
Practice Address - Fax:714-577-5450
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC17420101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor