Provider Demographics
NPI:1366093668
Name:TAVIRA-NAVA, ANA LESLY
Entity type:Individual
Prefix:MS
First Name:ANA
Middle Name:LESLY
Last Name:TAVIRA-NAVA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4139 PARAMOUNT BLVD
Mailing Address - Street 2:SPACE 19
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660
Mailing Address - Country:US
Mailing Address - Phone:323-722-4529
Mailing Address - Fax:323-722-4450
Practice Address - Street 1:12021 S. WILMINGTON AVE.
Practice Address - Street 2:BLDG #18 SUITE 101
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059
Practice Address - Country:US
Practice Address - Phone:424-454-6001
Practice Address - Fax:323-722-4450
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program