Provider Demographics
NPI:1124792262
Name:CADRES, AYANA HANA (LEP)
Entity type:Individual
Prefix:
First Name:AYANA
Middle Name:HANA
Last Name:CADRES
Suffix:
Gender:F
Credentials:LEP
Other - Prefix:
Other - First Name:AYANA
Other - Middle Name:HANA
Other - Last Name:CADRES GUIDERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LEP
Mailing Address - Street 1:5057 SOUTHRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-1504
Mailing Address - Country:US
Mailing Address - Phone:310-699-1811
Mailing Address - Fax:
Practice Address - Street 1:5057 SOUTHRIDGE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-1504
Practice Address - Country:US
Practice Address - Phone:310-699-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3820103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool