Provider Demographics
NPI:1841738523
Name:STACIE ARAGON
Entity Type:Organization
Organization Name:STACIE ARAGON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LCSW
Authorized Official - Prefix:
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-330-2613
Mailing Address - Street 1:1100 OLYMPIC DR
Mailing Address - Street 2:#104
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-3223
Mailing Address - Country:US
Mailing Address - Phone:714-330-2613
Mailing Address - Fax:951-280-9866
Practice Address - Street 1:1100 OLYMPIC DR
Practice Address - Street 2:#104
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3223
Practice Address - Country:US
Practice Address - Phone:714-330-2613
Practice Address - Fax:951-280-9866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty