Provider Demographics
NPI:1780301507
Name:AYALA, ANA MARCELA (MS, CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:MARCELA
Last Name:AYALA
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 W RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-1543
Mailing Address - Country:US
Mailing Address - Phone:415-640-8641
Mailing Address - Fax:
Practice Address - Street 1:1140 W RIVIERA DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-1543
Practice Address - Country:US
Practice Address - Phone:415-640-8641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16507235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist