Provider Demographics
NPI:1194181826
Name:AGUILAR, DIANE MERCEDES (BA, MSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MERCEDES
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:BA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 GRANDVIEW CT.
Mailing Address - Street 2:APT. 11
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-2323
Mailing Address - Country:US
Mailing Address - Phone:707-450-8699
Mailing Address - Fax:
Practice Address - Street 1:801 EMPIRE ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5702
Practice Address - Country:US
Practice Address - Phone:707-425-5744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical