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General NPI Number Information
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NPI Number | 1811873417
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Entity Type | Individual
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Provider Name | ELYCIA AYRES WC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 500 ROSEVILLE PKWY APT 614
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City | ROSEVILLE
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State | CA
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Zip | 95747-4677
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Country | US
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Telephone | 805-538-9240
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Fax |
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Provider Business Mailing Address
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Address Line | 6767 GREEN VALLEY RD
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City | PLACERVILLE
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State | CA
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Zip | 95667-8984
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Country | US
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Telephone |
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | EB20B13C16
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License Number State | CA
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