Provider Demographics
NPI:1326521964
Name:ULLOA, ANA MARIA (ASW129678)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:ULLOA
Suffix:
Gender:
Credentials:ASW129678
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 HOTEL CIR N STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2801
Mailing Address - Country:US
Mailing Address - Phone:619-481-3840
Mailing Address - Fax:
Practice Address - Street 1:1660 HOTEL CIR N STE 314
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2803
Practice Address - Country:US
Practice Address - Phone:619-961-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
171M00000X, 225400000X
CAASW1296781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner