Provider Demographics
NPI:1861991143
Name:AYALA, AMBERLEE CARLA (BSN, RN)
Entity type:Individual
Prefix:MISS
First Name:AMBERLEE
Middle Name:CARLA
Last Name:AYALA
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28008 MAGIC MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3535
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:251 E AVENUE K6 STE B
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4513
Practice Address - Country:US
Practice Address - Phone:661-405-3556
Practice Address - Fax:661-449-3772
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95040754163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse