Provider Demographics
NPI:1538792908
Name:AVILES, KARLA PAOLA
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:PAOLA
Last Name:AVILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:PAOLA
Other - Last Name:AVILES AYVAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2219 S HACIENDA BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4610
Mailing Address - Country:US
Mailing Address - Phone:626-764-0006
Mailing Address - Fax:
Practice Address - Street 1:2219 S HACIENDA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4610
Practice Address - Country:US
Practice Address - Phone:626-764-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician