Provider Demographics
NPI:1134997802
Name:AYALA, NATALIE ERICKA
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ERICKA
Last Name:AYALA
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 1:13865 HAWK CT
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-7572
Mailing Address - Country:US
Mailing Address - Phone:562-846-0553
Mailing Address - Fax:
Practice Address - Street 1:13865 HAWK CT
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-7572
Practice Address - Country:US
Practice Address - Phone:562-846-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other