Provider Demographics
NPI:1831442755
Name:AYALA, HEIDI JANAE (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:MISS
First Name:HEIDI
Middle Name:JANAE
Last Name:AYALA
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 S TOWNSEND AVE
Mailing Address - Street 2:NONE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-2420
Mailing Address - Country:US
Mailing Address - Phone:323-263-9700
Mailing Address - Fax:
Practice Address - Street 1:942 S ATLANTIC BLVD
Practice Address - Street 2:NONE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-4004
Practice Address - Country:US
Practice Address - Phone:323-263-9700
Practice Address - Fax:323-263-8042
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health