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NPI Code Detail

MEDICARE: MARILYN YAJAIRA AVILEZ

MEDICARE: MARILYN YAJAIRA AVILEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1669982823
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN YAJAIRA AVILEZ
Provider Business Mailing Address
First Line : 225 S LAKE AVE STE 300
Second Line :
City : PASADENA
State : CA
Zip : 91101-3009
Country : US
Telephone Number : 626-432-7270
Fax Number :
Provider Business Practice Location Address
First Line : 225 S LAKE AVE STE 300
Second Line :
City : PASADENA
State : CA
Zip : 91101-3009
Country : US
Telephone Number : 626-432-7270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2017
Last Update Date : 06/10/2020

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Directions to “ MARILYN YAJAIRA AVILEZ ” Practice Location

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