Healthcare Provider Details

I. General information

NPI: 1164350328
Provider Name (Legal Business Name): MARIA ANTONIA EK EWELL LEP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10840 PANGBORN AVE
DOWNEY CA
90241-4065
US

IV. Provider business mailing address

10840 PANGBORN AVE
DOWNEY CA
90241-4065
US

V. Phone/Fax

Practice location:
  • Phone: 323-440-7017
  • Fax:
Mailing address:
  • Phone: 323-440-7017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLEP
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: