Provider Demographics
NPI:1861852105
Name:MOLINA, AIMEE ELOISA
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:ELOISA
Last Name:MOLINA
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 1:257 LUCERNE AVE
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2011
Mailing Address - Country:US
Mailing Address - Phone:831-428-2123
Mailing Address - Fax:
Practice Address - Street 1:5523 SCOTTS VALLEY DR
Practice Address - Street 2:SUITE 108
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-3450
Practice Address - Country:US
Practice Address - Phone:831-706-6962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist