Healthcare Provider Details

I. General information

NPI: 1659943025
Provider Name (Legal Business Name): OLIVER RAYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 LIVE OAK ST
BELL GARDENS CA
90201-4616
US

IV. Provider business mailing address

2088 S ATLANTIC BLVD # 237
MONTEREY PARK CA
91754-6304
US

V. Phone/Fax

Practice location:
  • Phone: 562-927-1319
  • Fax: 323-313-0453
Mailing address:
  • Phone: 323-207-8740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number148821
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: