Individual provider Active NPI

Eden Saray Avila, PA-C

  • Physician Assistant
  • Riverside, CA
National Provider Identifier
1922683515
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA59443 Issued in CA
Practice address
5885 Brockton Ave
Riverside, CA 92506-1863
Phone
(619) 614-4933
Fax
(800) 680-3626
NPI assigned
Mar 15, 2021
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA59443 CA Primary

Addresses

Primary practice location

5885 Brockton Ave
Riverside, CA 92506-1863

Mailing address

PO Box 39614
Los Angeles, CA 90039-0614
Phone (619) 614-4933

Other practice location 1

4201 Long Beach Blvd Ste 203
Long Beach, CA 90807-2020
Phone (562) 997-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1922683515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39614",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900390614",
            "telephone_number": "619-614-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061863",
            "telephone_number": "619-614-4933",
            "fax_number": "800-680-3626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Long Beach Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908072020",
            "country_code": "US",
            "telephone_number": "562-997-7100",
            "fax_number": "562-981-9423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVILA",
        "first_name": "EDEN",
        "middle_name": "SARAY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.