Fausto Licona Ayala
NPI #1588413033 in San Fernando, California
Provider Information
- NPI Number
- 1588413033
- Entity Type
- Individual
- Name
- Fausto Licona Ayala
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- May 16, 2024
- Last Updated
- May 16, 2024
Practice Location
- Address
- 762 GRISWOLD AVE
- City
- San Fernando
- State
- California
- ZIP Code
- 91340
- Phone
- (747) 500-9405
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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