Provider Demographics
NPI:1558715920
Name:AGUILAR, MARCOS DAVID JR (MA, BCBA)
Entity Type:Individual
Prefix:MR
First Name:MARCOS
Middle Name:DAVID
Last Name:AGUILAR
Suffix:JR
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 W 41ST PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90062-1406
Mailing Address - Country:US
Mailing Address - Phone:323-217-6986
Mailing Address - Fax:
Practice Address - Street 1:2028 W 41ST PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062-1406
Practice Address - Country:US
Practice Address - Phone:323-217-6986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-16-21610103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst