Provider Demographics
NPI:1891249215
Name:AGUILAR, ERNEDA KATRINA
Entity Type:Individual
Prefix:
First Name:ERNEDA
Middle Name:KATRINA
Last Name:AGUILAR
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 1:1607 E PALMDALE BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4880
Mailing Address - Country:US
Mailing Address - Phone:661-233-8400
Mailing Address - Fax:
Practice Address - Street 1:1607 E PALMDALE BLVD STE D
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4880
Practice Address - Country:US
Practice Address - Phone:661-233-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA56CCOtherASPIRA