Provider Demographics
NPI:1235658881
Name:AGUILAR, AMETHYST KABRINA
Entity Type:Individual
Prefix:
First Name:AMETHYST
Middle Name:KABRINA
Last Name:AGUILAR
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 1:9015 MURRAY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3617
Mailing Address - Country:US
Mailing Address - Phone:408-665-4908
Mailing Address - Fax:
Practice Address - Street 1:9015 MURRAY AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020
Practice Address - Country:US
Practice Address - Phone:408-665-4908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor