Provider Demographics
NPI:1376327189
Name:AGUILAR, AVA LAUREN
Entity Type:Individual
Prefix:
First Name:AVA
Middle Name:LAUREN
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 1:2547 W SHAW AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3321
Mailing Address - Country:US
Mailing Address - Phone:559-241-7233
Mailing Address - Fax:
Practice Address - Street 1:2547 W SHAW AVE STE 113
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3321
Practice Address - Country:US
Practice Address - Phone:559-241-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst