Healthcare Provider Details

I. General information

NPI: 1285519983
Provider Name (Legal Business Name): ELVIA N/A AMBRIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11799 SEBASTIAN WAY STE 103
RANCHO CUCAMONGA CA
91730-0708
US

IV. Provider business mailing address

6221 STOVER AVE # A
RIVERSIDE CA
92505-1149
US

V. Phone/Fax

Practice location:
  • Phone: 909-276-0877
  • Fax:
Mailing address:
  • Phone: 951-751-2954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: