Provider Demographics
NPI:1740988245
Name:INCE, AYANA MONIQUE (PSYD)
Entity type:Individual
Prefix:DR
First Name:AYANA
Middle Name:MONIQUE
Last Name:INCE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 E GARFORD ST APT 98
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2856
Mailing Address - Country:US
Mailing Address - Phone:818-450-6942
Mailing Address - Fax:
Practice Address - Street 1:5050 E GARFORD ST APT 98
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2856
Practice Address - Country:US
Practice Address - Phone:818-450-6942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33905103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical