Provider Demographics
NPI:1205028628
Name:FORESTIER, ROSALIE AGUILAR
Entity Type:Individual
Prefix:MRS
First Name:ROSALIE
Middle Name:AGUILAR
Last Name:FORESTIER
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 1:22471 ASPAN ST
Mailing Address - Street 2:103
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-1642
Mailing Address - Country:US
Mailing Address - Phone:949-458-2715
Mailing Address - Fax:
Practice Address - Street 1:22471 ASPAN ST
Practice Address - Street 2:103
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1642
Practice Address - Country:US
Practice Address - Phone:949-458-2715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health