Provider Demographics
NPI:1265175137
Name:AYALA, EVELYN ESTELA (PHD)
Entity type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:ESTELA
Last Name:AYALA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 VICTOR AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4023
Mailing Address - Country:US
Mailing Address - Phone:951-241-6234
Mailing Address - Fax:
Practice Address - Street 1:3455 KNIGHTON RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-9498
Practice Address - Country:US
Practice Address - Phone:530-226-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling