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Dr. Tiffany Juliette Avila, MD

Accepting New Patients
(Dr. Tiffany Juliette Avila Powell, MD)
Specializes in: Spine Surgery and Neurosurgery
Wayne State University School of Medicine (2005)
Professional interests include: peripheral nerve surgery, brain surgery, cervical laminoplasty, and more.
2675 Harris Street
Eureka, CA 95503

Dr. Tiffany Juliette Avila, MD is a spine surgeon in Palm Springs, CA specializing in spine surgery and neurosurgery. She graduated from Wayne State University School of Medicine in 2005 and has 21 years of experience. Dr. Tiffany Juliette Avila, MD is affiliated with Providence, Providence Holy Cross Medical Center and Providence Medical Foundation.

View Doctor's Full Profile (707) 268-0190

Office Locations

1150 N Indian Canyon Drive
Palm Springs, CA 92262
(760) 325-1202
open_in_new

Providence Holy Cross Medical Center

2675 Harris Street
Eureka, CA 95503
(707) 268-0190
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Some issues Dr. Tiffany Juliette Avila, MD can help you with:

Craniotomy

Craniotomy and craniectomy are surgical procedures used to access the brain and treat tumors, intracranial pressure, or other conditions. These surgeries are performed by creating holes in the skull, or cranium, to expose the brain. The opening in the skull can be immediately replaced (craniotomy), or it can be replaced during a later procedure (craniectomy). The following procedures use craniotomy or craniectomy:

  • Brain biopsy, which is done by guiding a needle through the opening in the skull to the targeted area of the brain. This procedure may be performed through an open or minimally invasive approach. The minimally invasive approach, called stereotactic brain biopsy, uses a computer to guide the needle.
  • Brain tumor resection, which may be performed following a biopsy with image guidance. Depending on the size and location of the tumor, resection will require 2-5 hours.
  • Cerebrospinal fluid (CSF) leak repair, particularly for leaks that continue for a long period of time after a surgery. CSF leaks that are left untreated can lead to complications such as meningitis, an inflammation of the outer layers (meninges) of the brain.
  • Decompression, often following a stroke or injury. Decompressive craniotomy or craniectomy temporarily removes a flap from the skull to give the brain more room for swelling, which provides pressure relief.
  • Hematoma evacuation, which can also relieve pressure on the brain. A hematoma is a swelling of clotted blood. It can occur between the skull and the outer covering of the brain, or dura (epidural), between the dura and the brain (subdural), and within the brain (intracerebral). Craniotomy or craniectomy may be used to access and remove the hematoma.

To perform a craniotomy, the surgeon will need to make an incision on the scalp to expose the skull. Some of the hair may be shaved, and the scalp will be cleaned with antiseptic solution. Following the incision, the surgeon will use a drill to remove a piece of the skull, called a bone or skull flap. If the surgeon needs to reach a tumor or perform an aspiration, the dura, which covers the brain, will be incised (cut) to access the lesion. The bone flap will be reattached once the surgeon has completed the procedure. If the surgeon is performing a craniectomy, the same steps will be followed, but a mesh piece will be placed where the bone flap was, and the scalp will be surgically closed. Patients will need to wear a special helmet for a few months after the procedure. The bone flap will be preserved and replaced during a later operation, or it may never be replaced.

Patient recovery period can range from two days to two weeks, depending on the specific procedure and condition. Patient will require monitoring and may be given medication for pain or brain swelling. Patients will have to restrict their physical activity for some time after the procedure, and they may need to work with a physical therapist.

Hydrocephalus

Normally, the brain is bathed in a liquid called cerebrospinal fluid. This fluid cushions and nurtures the brain cells as it flows around and through the brain. Sometimes, cerebrospinal fluid does not get reabsorbed into the body properly, or a blockage in the brain can stop it from flowing. This causes a buildup of pressure called hydrocephalus. This condition affects a wide range of people, but it is much more prevalent among infants and older adults. Left untreated, hydrocephalus can cause uncomfortable symptoms, such as headaches and blurred vision, and eventually may cause brain damage.

Hydrocephalus is most often treated with an implanted device called a shunt. A shunt is a long, thin tube that is used to drain excess fluid. One end is placed within the brain. The tube runs under the skin, along the neck behind the ear, and to another part of the body where the fluid can be reabsorbed. Most often this is the abdomen, but the chest or other areas can also be used. Shunts have a valve that allows doctors to monitor and control the pressure within the brain. Insertion of a shunt is a surgical procedure that takes one to two hours. Incisions are made in the head and the abdomen, and the shunt is threaded into place before the openings are stitched closed.

In cases where hydrocephalus is caused by a blockage, a procedure called endoscopic third ventriculostomy, or ETV, may be performed. During this procedure, a surgeon makes a dime-sized hole in the skull and uses a thin tube with a camera on the end (called an endoscope) to see inside the brain. The surgeon punctures a hole in the floor of the third ventricle, a fluid-filled space within the brain. The hole provides an opening for cerebrospinal fluid to flow around the blockage, normalizing pressure. The entire procedure usually takes less than an hour and patients can often go home the following day. ETV can provide a permanent and safe alternative to a shunt, but it is only useful for patients whose hydrocephalus is caused by a blockage.

Spinal Fusion

Spinal fusion is a surgical procedure to permanently join together two or more vertebrae, the bones in the spine. Certain spinal disorders can lead to instability and pain, and the idea behind spinal fusion is that fusing vertebrae together can both make them stronger and reduce motion, which can sometimes reduce pain.

There are several different types of spinal fusion surgery available, mostly depending on where a patient's pain is located and whether his or her surgeon will perform the procedure through the back, front, or side. In general, a fusion is performed by packing the vertebrae to be fused with grafted bone. This bone may be taken from the patient's hip, may be donated from a cadaver, or it may be a manufactured synthetic material. The bone is placed along the vertebrae, and sometimes, the disc that lies in between the vertebrae is removed and replaced with grafted bone. The bone material will grow and cement the two vertebrae together. After the bone graft is placed, the vertebrae are sometimes held in place with rods, screws, plates, or cages, depending on the weakness of the spine and needs of the graft.

Spinal fusion is a significant surgery and can take three to four hours or more. Recovery is typically two to four days in the hospital. After surgery, it is important to remember that the fusion takes time to grow from the bone graft. So, the actual fusion is not complete for several months. Patients will probably feel somewhat better right away, but it may take a while to feel the full effects of the fusion as the bone grows into place. In the meantime, doctors might have patients wear a brace to protect their spine and keep it properly aligned.

Spinal fusion is not used for all kinds of back pain. Changing the way the spine moves can lead to strain on the other joints in the back, and fusion is only performed when the benefits outweigh the risks. Some spine disorders that are treated with fusion include:

  • Curvature disorders, such as scoliosis and kyphosis
  • Degenerative disc disease
  • Spondylolisthesis, a disorder that causes vertebrae to slip over each other
  • Significant spinal fractures that cause instability
  • Weakened spine due to infection or tumor
  • Some cases of spinal stenosis, a narrowing of the spinal column
  • Chronic lower back pain (although the use of fusion to treat this is controversial)

Regardless of the diagnosis, there is always a possibility of 'failure' with spinal fusion, or of the surgery not fully solving the pain. This is more likely when fusion is used primarily to treat pain instead of structural problems. Patients can improve their chances of a successful outcome by stopping smoking, maintaining a healthy weight, moving their body every day, and following their doctor's instructions for any physical therapy that they are prescribed.

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

doctor visit 19

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2013 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

hospital care 53
inpatient care 53

2013 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 11
Female 21
Ethnicity
Non-Hispanic White 21
Black 0
Hispanic 0
Asian 0
Other 0
Native American 0
Age
From 65 to 74 12
From 75 to 84 0
85 and over 0
Less than 65 0

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2013

Hypertension 75
High Cholesterol 66
Stroke 44
Ischemic Heart Disease 41
Depression 38
Chronic Kidney Disease 0
Asthma 0
Osteoperosis 0
Atrial Fibrilation 0
Heart Failure 0
Chronic Obstructive Pulmonary Disease 0
Diabetes 0
Dementia 0
Cancer 0

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2014 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

hospital care 51
inpatient care 51

2014 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 28
Female 25
Ethnicity
Non-Hispanic White 42
Black 0
Hispanic 0
Asian 0
Other 0
Native American 0
Age
From 65 to 74 19
From 75 to 84 18
85 and over 0
Less than 65 0

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2014

Hypertension 75
High Cholesterol 70
Stroke 43
Ischemic Heart Disease 38
Depression 40
Chronic Kidney Disease 43
Asthma 0
Osteoperosis 0
Atrial Fibrilation 25
Heart Failure 28
Chronic Obstructive Pulmonary Disease 0
Diabetes 36
Dementia 30
Cancer 0

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2015 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

doctor visit 44
hospital care 105
inpatient care 105

2015 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 92
Female 92
Ethnicity
Non-Hispanic White 136
Black 0
Hispanic 0
Asian 0
Other 0
Native American 0
Age
From 65 to 74 60
From 75 to 84 66
85 and over 0
Less than 65 0

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2015

Hypertension 75
High Cholesterol 73
Stroke 42
Ischemic Heart Disease 41
Depression 35
Chronic Kidney Disease 47
Asthma 0
Osteoperosis 0
Atrial Fibrilation 18
Heart Failure 24
Chronic Obstructive Pulmonary Disease 15
Diabetes 38
Dementia 30
Cancer 24

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2016 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

hospital care 99
inpatient care 99

2016 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 28
Female 39
Ethnicity
Non-Hispanic White 33
Black 0
Hispanic 0
Asian 0
Other 0
Native American 0
Age
From 65 to 74 21
From 75 to 84 22
85 and over 0
Less than 65 0

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2016

Hypertension 75
High Cholesterol 60
Stroke 42
Ischemic Heart Disease 49
Depression 48
Chronic Kidney Disease 52
Asthma 16
Osteoperosis 0
Atrial Fibrilation 18
Heart Failure 33
Chronic Obstructive Pulmonary Disease 0
Diabetes 58
Dementia 46
Cancer 0

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2017 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

doctor visit 62
hospital care 172
inpatient care 172

2017 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 55
Female 73
Ethnicity
Non-Hispanic White 60
Black 0
Hispanic 50
Asian 0
Other 0
Native American 0
Age
From 65 to 74 47
From 75 to 84 32
85 and over 20
Less than 65 29

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2017

Hypertension 75
High Cholesterol 55
Stroke 27
Ischemic Heart Disease 44
Depression 39
Chronic Kidney Disease 51
Asthma 12
Osteoperosis 19
Atrial Fibrilation 18
Heart Failure 41
Chronic Obstructive Pulmonary Disease 29
Diabetes 49
Dementia 27
Cancer 12

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2018 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

doctor visit 59
hospital care 95
inpatient care 95

2018 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 36
Female 56
Ethnicity
Non-Hispanic White 47
Black 0
Hispanic 26
Asian 0
Other 0
Native American 0
Age
From 65 to 74 27
From 75 to 84 25
85 and over 16
Less than 65 24

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2018

Hypertension 75
High Cholesterol 64
Stroke 22
Ischemic Heart Disease 35
Depression 54
Chronic Kidney Disease 48
Asthma 16
Osteoperosis 22
Atrial Fibrilation 13
Heart Failure 35
Chronic Obstructive Pulmonary Disease 29
Diabetes 46
Dementia 33
Cancer 13

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2019 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

doctor visit 74
hospital care 118
inpatient care 118

2019 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 59
Female 54
Ethnicity
Non-Hispanic White 45
Black 0
Hispanic 47
Asian 0
Other 0
Native American 0
Age
From 65 to 74 45
From 75 to 84 29
85 and over 17
Less than 65 22

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2019

Hypertension 75
High Cholesterol 60
Stroke 18
Ischemic Heart Disease 43
Depression 41
Chronic Kidney Disease 49
Asthma 0
Osteoperosis 18
Atrial Fibrilation 10
Heart Failure 37
Chronic Obstructive Pulmonary Disease 18
Diabetes 49
Dementia 26
Cancer 0

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2020 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

doctor visit 13
hospital care 31
inpatient care 31

2020 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 24
Female 28
Ethnicity
Non-Hispanic White 26
Black 0
Hispanic 0
Asian 0
Other 0
Native American 0
Age
From 65 to 74 24
From 75 to 84 0
85 and over 0
Less than 65 0

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2020

Hypertension 75
High Cholesterol 67
Stroke 35
Ischemic Heart Disease 35
Depression 38
Chronic Kidney Disease 46
Asthma 0
Osteoperosis 21
Atrial Fibrilation 0
Heart Failure 42
Chronic Obstructive Pulmonary Disease 25
Diabetes 35
Dementia 33
Cancer 21

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA during 2021 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

hospital care 48
inpatient care 48

2021 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 25
Female 31
Ethnicity
Non-Hispanic White 27
Black 0
Hispanic 17
Asian 0
Other 0
Native American 0
Age
From 65 to 74 27
From 75 to 84 0
85 and over 0
Less than 65 0

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2021

Hypertension 73
High Cholesterol 66
Stroke 25
Ischemic Heart Disease 36
Depression 41
Chronic Kidney Disease 52
Asthma 0
Osteoperosis 29
Atrial Fibrilation 0
Heart Failure 41
Chronic Obstructive Pulmonary Disease 0
Diabetes 39
Dementia 29
Cancer 0

Medicare Procedure and Patient Information

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2022

Hypertension 75
High Cholesterol 0
Stroke 0
Ischemic Heart Disease 0
Depression 0
Chronic Kidney Disease 0
Asthma 0
Osteoperosis 0
Atrial Fibrilation 0
Heart Failure 0
Chronic Obstructive Pulmonary Disease 0
Diabetes 0
Dementia 0
Cancer 0

Medicare Procedure and Patient Information

2023 Medicare Procedure Volume

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

doctor visit 31

2023 Medicare Patient Data

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 30
Female 26
Age
From 65 to 74 21
From 75 to 84 18
85 and over 0
Less than 65 0

Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD in 2023

Hypertension 75
High Cholesterol 66
Stroke 0
Ischemic Heart Disease 0
Depression 34
Chronic Kidney Disease 21
Asthma 0
Osteoperosis 0
Atrial Fibrilation 0
Heart Failure 21
Chronic Obstructive Pulmonary Disease 21
Diabetes 0
Dementia 0
Cancer 0

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2023

Volume of procedures performed by Dr. Tiffany Juliette Avila, MD for Medicare patients.

The highest averages for the top procedures that Dr. Tiffany Juliette Avila, MD treated as a spine surgeon in Palm Springs, CA were hospital care and inpatient care.

doctor visit 43
hospital care 85
inpatient care 85

Average Medicare Patient Data From 2012 - 2023

Information about Medicare patients treated by Dr. Tiffany Juliette Avila, MD.

Gender
Male 32
Female 37
Ethnicity
Black / African American 0
Asian / Pacific Islander 0
Non-Hispanic White 36
Hispanic 11
Native American / Alaskan Native 0
Other 0
Age
75 to 84 17
85 and over 4
Less than 65 6
65 to 74 25

Average of Total of Conditions of Medicare patients treated by Dr. Tiffany Juliette Avila, MD From 2012 - 2023

The highest averages of the most common conditions of Medicare patients that Dr. Tiffany Juliette Avila, MD treated were hypertension, high cholesterol, chronic kidney disease and depression.

Hypertension 68
High Cholesterol 53
Stroke 24
Ischemic Heart Disease 30
Depression 34
Chronic Kidney Disease 34
Asthma 3
Osteoporosis 9
Heart Failure 25
Chronic Obstructive Pulmonary Disease 11
Diabetes 29
Atrial Fibrillation 8
Cancer 5
Dementia 21

Education & Training

Dr. Tiffany Juliette Avila, MD graduated from Wayne State University School of Medicine in 2005. She completed residency at Virginia Commonwealth University (VCU) Affiliated Hospitals. She is certified by the American Board of Pediatrics, Neurological Surgery and has a state license in District of Columbia.

Medical School: Wayne State University School of Medicine (2005)

Residency: Virginia Commonwealth University (VCU) Affiliated Hospitals (2011)

Board Certification: American Board of Pediatrics, Neurological Surgery

Licensed In: District of Columbia

Affiliations & Hospitals

Dr. Tiffany Juliette Avila, MD is associated with these hospitals and organizations:

Providence
Providence Holy Cross Medical Center
Providence Medical Foundation

Insurance Information

Please note: Insurance information may change at any time, and the provider may accept your insurance plan even if it is not listed below. Please contact the provider's office to confirm that your insurance is accepted.

Dr. Tiffany Juliette Avila, MD appears to accept the following insurance providers: Aetna PPO, Aetna HMO, CIGNA PPO, Western Health Advantage HMO, Blue Shield of California, MultiPlan PPO, Medicare Advantage, HealthSmart, Interplan PPO, TriWest, Anthem Blue Cross PPO, Health Net PPO, Anthem, Coventry PPO, United Healthcare PPO, US Family Health Plan, Aetna Medicare PPO, Partnership Health Plan of California and CoventryFirst Health PPO.

Insurance Accepted by Provider includes:

According to our sources, Dr. Tiffany Juliette Avila, MD accepts the following insurance providers:

Aetna PPO
Aetna HMO
CIGNA PPO
Western Health Advantage HMO
Blue Shield of California
MultiPlan PPO
Medicare Advantage
HealthSmart
Interplan PPO
TriWest
Anthem Blue Cross PPO
Health Net PPO
Anthem
Coventry PPO
United Healthcare PPO
US Family Health Plan
Aetna Medicare PPO
Partnership Health Plan of California
CoventryFirst Health PPO

Ratings & Reviews

Dr. Tiffany Juliette Avila, MD has an exceptional overall rating with an average of 5.0 out of 5 stars based on 1 ratings. We collect ratings and reviews of Dr. Tiffany Juliette Avila, MD from all over the web to help you find the right in Palm Springs, CA. 

5
Overall Rating
Leave a Review
Reviews Left On DocSpot
Overall Rating: 5.0 2016-09-23 
Doctor performed Meningioma surgery, she was very caring and patient
She treated me like a patient and not a number. I felt very comfortable 
after the surgery. I would highly recommend Doctor Powell Avila

General Payments

These charts describe general payments received by Dr. Tiffany Juliette Avila, MD. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

Payments by Company
NUVASIVE, INC. $1,219 XLIF
$1,037 		TLIF
$65 		Osteocel
$17
$100
Boston Scientific Corporation $200 PAIN MANAGEMENT
$143 		GENERAL - ENDOCHOICE
$33
$24
DePuy Synthes Sales Inc. $153 Spine
$46 		MATRIXORTHOGNATHIC
$44 		MOUNTAINEER
$35 		CERTAS
$27
KARL STORZ Endoscopy-America $150 VITOM 90 DETACHABLE, AUTOCLAVE
$150
Zimmer Biomet Holdings, Inc. $149 ROI A
$108 		Biomet SpinalPak
$41
Other $1,073 Neuro-Chronic Pain
$118 		Altera
$85 		OFIRMEV
$56 		Duragen
$51 		Senza Spinal Cord Stimulation System
$49 		Other
$714
Types of Payments
Food and Beverage $2,274
Travel and Lodging $648
Gift $23

Biography

Dr. Tiffany Avila is a specialist in spine surgery and neurosurgery in Eureka, CA and Palm Springs, CA. Clinical interests for Dr. Avila include spinal embolization, bypass surgery, and kyphoplasty (vertebral augmentation). She seems to honor several insurance carriers, including Anthem, Blue California, and HealthSmart. She attended Wayne State University School of Medicine and then went on to complete her residency at a hospital affiliated with Virginia Commonwealth University (VCU). Her hospital/clinic affiliations include Providence Holy Cross Medical Center and Providence Medical Foundation. According to Providence Medical Foundation, new patients are welcome to contact Dr. Avila's office in Eureka, CA.

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