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General NPI Number Information
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NPI Number | 1366093668
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Entity Type | Individual
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Provider Name | MS. ANA LESLY TAVIRA-NAVA
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Gender | Female
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Dates
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Enumeration Date | 09/27/2019
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 12021 S. WILMINGTON AVE. BLDG #18 SUITE 101
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City | LOS ANGELES
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State | CA
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Zip | 90059
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Country | US
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Telephone | 424-454-6001
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Fax | 323-722-4450
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Provider Business Mailing Address
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Address Line | 4139 PARAMOUNT BLVD SPACE 19
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City | PICO RIVERA
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State | CA
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Zip | 90660
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Country | US
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Telephone | 323-722-4529
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Fax | 323-722-4450
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Authorized Official
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Title or Position |
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Name |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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