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General NPI Number Information
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NPI Number | 1114674678
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Entity Type | Individual
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Provider Name | GRISELDA AYALA
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Gender | Female
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 7171 BOWLING DR STE 300
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City | SACRAMENTO
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State | CA
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Zip | 95823-2043
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Country | US
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Telephone | 415-910-1765
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 725
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City | SACRAMENTO
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State | CA
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Zip | 95812-0725
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Country | US
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Telephone | 916-957-7929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW124111
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License Number State | CA
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