Provider Demographics
NPI:1710463393
Name:AGUAYO, BIANCA N
Entity Type:Individual
Prefix:MISS
First Name:BIANCA
Middle Name:N
Last Name:AGUAYO
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 1:15010 VENETIAN WAY
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-6029
Mailing Address - Country:US
Mailing Address - Phone:408-310-1463
Mailing Address - Fax:
Practice Address - Street 1:15010 VENETIAN WAY
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-6029
Practice Address - Country:US
Practice Address - Phone:408-310-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst