Provider Demographics
NPI:1033731005
Name:AGUILAR, JIANNA MICHELLE (ATC)
Entity Type:Individual
Prefix:
First Name:JIANNA
Middle Name:MICHELLE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-1553
Mailing Address - Country:US
Mailing Address - Phone:951-533-2358
Mailing Address - Fax:
Practice Address - Street 1:16150 POMONA RINCON RD
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3101
Practice Address - Country:US
Practice Address - Phone:909-606-7540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer