Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fausto Licona Ayala

Individual provider Case Manager/Care Coordinator · NPI 1588413033

Fausto Licona Ayala is a Case Manager/Care Coordinator in San Fernando, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

762 Griswold Ave
San Fernando, CA 91340
Phone: (747) 500-9405
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X · Licence 16759-RAC (CA)

Record details

NPI number1588413033
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 16, 2024
Last updated in NPPESMay 16, 2024

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