Provider Demographics
NPI:1790331908
Name:AGUILAR, ALLISON CHRISTINE (RN, PHN, CSN)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:CHRISTINE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:RN, PHN, CSN
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:CHRISTINE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1777 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-4800
Mailing Address - Country:US
Mailing Address - Phone:209-827-0120
Mailing Address - Fax:209-827-3552
Practice Address - Street 1:1777 S 11TH ST
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-4800
Practice Address - Country:US
Practice Address - Phone:209-827-0120
Practice Address - Fax:209-827-3552
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69749163WC1500X
CA656007163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health