Provider Demographics
NPI:1851624241
Name:AGUINIGA, JULIE RENAE (LCSW, PPS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RENAE
Last Name:AGUINIGA
Suffix:
Gender:F
Credentials:LCSW, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMAN
Mailing Address - State:CA
Mailing Address - Zip Code:95360-1119
Mailing Address - Country:US
Mailing Address - Phone:209-862-3670
Mailing Address - Fax:209-862-3426
Practice Address - Street 1:890 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWMAN
Practice Address - State:CA
Practice Address - Zip Code:95360-1119
Practice Address - Country:US
Practice Address - Phone:209-862-3670
Practice Address - Fax:209-862-3426
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA751221041C0700X
CA31602101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health