Provider Demographics
NPI:1457009466
Name:AGUILAR, ANDRES G JR
Entity Type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:G
Last Name:AGUILAR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1797 SAN JOSE AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-3078
Mailing Address - Country:US
Mailing Address - Phone:559-298-0699
Mailing Address - Fax:
Practice Address - Street 1:1797 SAN JOSE AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-3078
Practice Address - Country:US
Practice Address - Phone:559-298-0699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor