Provider Demographics
NPI:1003414202
Name:AGUILAR, ARIANNA D (HIGH SCHOOL DIPLOMA)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:D
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:HIGH SCHOOL DIPLOMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 HIGHWAY 111 SUITE 102
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260
Mailing Address - Country:US
Mailing Address - Phone:323-475-7407
Mailing Address - Fax:323-475-7407
Practice Address - Street 1:7410 HIGHWAY 111 SUITE 102
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260
Practice Address - Country:US
Practice Address - Phone:323-475-7407
Practice Address - Fax:323-475-7407
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst