Healthcare Provider Details

I. General information

NPI: 1497585657
Provider Name (Legal Business Name): CARISMA AYALA ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S C ST STE D
OXNARD CA
93033-4574
US

IV. Provider business mailing address

PO BOX 5692
OXNARD CA
93031-5692
US

V. Phone/Fax

Practice location:
  • Phone: 805-654-5129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: