Healthcare Provider Details

I. General information

NPI: 1609795020
Provider Name (Legal Business Name): KATHERINE STEPHANIE AYALA MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 RUGBY AVE
HUNTINGTON PARK CA
90255-4040
US

IV. Provider business mailing address

335 E COLDEN AVE
LOS ANGELES CA
90003-4316
US

V. Phone/Fax

Practice location:
  • Phone: 323-588-1177
  • Fax:
Mailing address:
  • Phone: 323-605-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040464
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: