Provider Demographics
NPI:1881212389
Name:VELASCO ACUNA, AYLIN MAYAN
Entity type:Individual
Prefix:
First Name:AYLIN
Middle Name:MAYAN
Last Name:VELASCO ACUNA
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 1:276 PRESIDIO AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-5474
Mailing Address - Country:US
Mailing Address - Phone:559-544-0931
Mailing Address - Fax:
Practice Address - Street 1:1150 E SEQUOIA AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-4508
Practice Address - Country:US
Practice Address - Phone:559-556-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other