Provider Demographics
NPI:1659712198
Name:AGUIRRE, KIMBERLY (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 VIA ALONDRA
Mailing Address - Street 2:SUITE 611-A
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8095
Mailing Address - Country:US
Mailing Address - Phone:805-383-5566
Mailing Address - Fax:888-659-0031
Practice Address - Street 1:621 VIA ALONDRA
Practice Address - Street 2:SUITE 611-A
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8095
Practice Address - Country:US
Practice Address - Phone:805-383-5566
Practice Address - Fax:888-659-0031
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-13434103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst