Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ASW89903 | CA |
NPI | 1003260647 |
---|---|
Provider Name | Ariana Ventura Ayala |
First Address | El Monte, CA 91732-2510 |
Second Address | El Monte, CA 91732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2016 |
Last Update Date | 15/07/2019 |