Individual
NICOLE DIANE AYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9412 BIG HORN BLVD STE 69412, ELK GROVE, CA 95758-1101
(916) 609-5100
Mailing address
8779 ELK WAY, ELK GROVE, CA 95624-1651
(916) 873-9793
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
06/18/2025
Last updated
12/01/2025
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