Healthcare Provider Details

I. General information

NPI: 1801712195
Provider Name (Legal Business Name): MS. AIMEE DYAN NAVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2813 S MAIN ST FL 2
CORONA CA
92882-5942
US

IV. Provider business mailing address

7873 PINERIDGE CT
JURUPA VALLEY CA
92509-7024
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-4840
  • Fax:
Mailing address:
  • Phone: 760-995-6798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: