Provider Demographics
NPI:1902587512
Name:AYOUBI, TIARA (BA)
Entity type:Individual
Prefix:MS
First Name:TIARA
Middle Name:
Last Name:AYOUBI
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23041 AVENIDA DE LA CARLOTA STE 175
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1588
Mailing Address - Country:US
Mailing Address - Phone:949-954-4422
Mailing Address - Fax:
Practice Address - Street 1:23041 AVENIDA DE LA CARLOTA STE 175
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1588
Practice Address - Country:US
Practice Address - Phone:949-954-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician