Provider Demographics
NPI:1245424738
Name:PRASAD-AGUILERA, ANITA MARGARET (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:MARGARET
Last Name:PRASAD-AGUILERA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ANITA
Other - Middle Name:MARGARET
Other - Last Name:PRASAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4532 N DELNO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-1019
Mailing Address - Country:US
Mailing Address - Phone:559-577-0235
Mailing Address - Fax:
Practice Address - Street 1:1300 E SHAW AVE STE 109
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7903
Practice Address - Country:US
Practice Address - Phone:559-712-8800
Practice Address - Fax:559-712-8805
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW932561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical