Provider Demographics
NPI:1467618371
Name:AGUILAR, ANTONIA MARINA (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANTONIA
Middle Name:MARINA
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:MARINA
Other - Middle Name:
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:9130 STEELE CANYON RD
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-9104
Mailing Address - Country:US
Mailing Address - Phone:707-492-2943
Mailing Address - Fax:
Practice Address - Street 1:1141 DIVISION ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3333
Practice Address - Country:US
Practice Address - Phone:707-492-2943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 30536106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist