Healthcare Provider Details

I. General information

NPI: 1730084765
Provider Name (Legal Business Name): ANA ELIZABETH AVITIA BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21545 CENTRE POINTE PKWY
SANTA CLARITA CA
91350-2947
US

IV. Provider business mailing address

532 HARDING AVE
SAN FERNANDO CA
91340-2330
US

V. Phone/Fax

Practice location:
  • Phone: 661-259-9439
  • Fax: 661-259-9658
Mailing address:
  • Phone: 661-259-9439
  • Fax: 661-259-9658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: