Provider Demographics
NPI:1083390702
Name:AGUIRRE VERDUGO, ANAHISA
Entity Type:Individual
Prefix:
First Name:ANAHISA
Middle Name:
Last Name:AGUIRRE VERDUGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35470 WHITEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2415
Mailing Address - Country:US
Mailing Address - Phone:323-314-4796
Mailing Address - Fax:
Practice Address - Street 1:35470 WHITEWOOD RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2415
Practice Address - Country:US
Practice Address - Phone:951-246-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist