Healthcare Provider Details

I. General information

NPI: 1477269397
Provider Name (Legal Business Name): AYLIN AYALA-RIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16580 HARBOR BLVD STE M
FOUNTAIN VALLEY CA
92708-1385
US

IV. Provider business mailing address

16580 HARBOR BLVD STE M
FOUNTAIN VALLEY CA
92708-1385
US

V. Phone/Fax

Practice location:
  • Phone: 714-975-5201
  • Fax:
Mailing address:
  • Phone: 714-975-5201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC22175
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: