Provider Demographics
NPI:1497061402
Name:AGUADO, ANA BERTHA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:BERTHA
Last Name:AGUADO
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 1:225 WESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4168
Mailing Address - Country:US
Mailing Address - Phone:831-724-3885
Mailing Address - Fax:881-724-3534
Practice Address - Street 1:225 WESTRIDGE DR
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4168
Practice Address - Country:US
Practice Address - Phone:831-724-3885
Practice Address - Fax:881-724-3534
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health