Mitzi Ayala | Los Angeles, CA • PECOS Search

Mitzi Ayala

Counselor

Behavioral Health & Social Service Providers

5715 S Broadway, Los Angeles, CA 90037-4131

PECOS Enrollment

Based on the most recent information from CMS, provider Mitzi Ayala does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1235255613
Provider Type
Individual
Full Name
Ayala, Mitzi
Gender
Female

Sole Proprietor
No
Enumeration Date
3/21/2007
Last Updated
7/8/2007

Contact Information

Practice Location

5715 S Broadway, Los Angeles, CA 90037-4131

Unlisted Fax

Mailing Location

5715 S Broadway, Los Angeles, CA 90037-4131

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer