Provider Demographics
NPI:1609172436
Name:FLORES, MYRNA AGUILAR (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MYRNA
Middle Name:AGUILAR
Last Name:FLORES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-6001
Mailing Address - Country:US
Mailing Address - Phone:650-576-3329
Mailing Address - Fax:
Practice Address - Street 1:210 N 4TH ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5569
Practice Address - Country:US
Practice Address - Phone:408-295-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health