Provider Demographics
NPI:1164782710
Name:AGUILAR TAITAGUE, ARRIONNE CHRISTINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ARRIONNE
Middle Name:CHRISTINE
Last Name:AGUILAR TAITAGUE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ARRIONNE
Other - Middle Name:CHRISTINE
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:2025 MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2115
Mailing Address - Country:US
Mailing Address - Phone:916-692-9121
Mailing Address - Fax:
Practice Address - Street 1:14500 ROSCOE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4194
Practice Address - Country:US
Practice Address - Phone:916-692-9121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA786981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor