Provider Demographics
NPI:1891427316
Name:AGUILAR, RENA M
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:M
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 1:2250 HIGHLANDS RD
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-1044
Mailing Address - Country:US
Mailing Address - Phone:510-230-5007
Mailing Address - Fax:
Practice Address - Street 1:500 ALFRED NOBEL DR STE 275
Practice Address - Street 2:
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-1838
Practice Address - Country:US
Practice Address - Phone:510-230-5007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide