Provider Demographics
NPI:1407210859
Name:AVILES, HUGO
Entity Type:Individual
Prefix:
First Name:HUGO
Middle Name:
Last Name:AVILES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HUGO
Other - Middle Name:
Other - Last Name:AVILES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4324 MINK CT
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-7796
Mailing Address - Country:US
Mailing Address - Phone:925-204-0428
Mailing Address - Fax:
Practice Address - Street 1:4324 MINK CT
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-7796
Practice Address - Country:US
Practice Address - Phone:925-204-0428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst