Provider Demographics
NPI:1437718038
Name:ANANI, PAMELA AYELE (PSYD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:AYELE
Last Name:ANANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 N 10TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4467
Mailing Address - Country:US
Mailing Address - Phone:323-812-2261
Mailing Address - Fax:
Practice Address - Street 1:2302 BROWN RD
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-0731
Practice Address - Country:US
Practice Address - Phone:323-812-2261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35560103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical