Individual
ANDREA MARIE AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1130 AVENIDA TALEGA, SAN CLEMENTE, CA 92673-6710
(949) 234-5955
Mailing address
1130 AVENIDA TALEGA, SAN CLEMENTE, CA 92673-6710
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
260010103
CA
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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