Provider Demographics
NPI:1861662124
Name:AGUILERA, ERIKA CARENA (MA)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:CARENA
Last Name:AGUILERA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:CARENA
Other - Last Name:GUZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4700 ENTERPRISE WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356
Mailing Address - Country:US
Mailing Address - Phone:209-550-6055
Mailing Address - Fax:209-550-6010
Practice Address - Street 1:4700 ENTERPRISE WAY
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356
Practice Address - Country:US
Practice Address - Phone:209-550-6055
Practice Address - Fax:209-550-6010
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1589101YP2500X
CALPCC2887101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional