Provider Demographics
NPI:1891881017
Name:AGUILERA, DANIEL HENRY (MSW PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:HENRY
Last Name:AGUILERA
Suffix:
Gender:M
Credentials:MSW PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 E FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-3404
Mailing Address - Country:US
Mailing Address - Phone:213-201-2786
Mailing Address - Fax:213-989-7701
Practice Address - Street 1:123 S ALVARADO STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2201
Practice Address - Country:US
Practice Address - Phone:213-989-7700
Practice Address - Fax:213-989-7702
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS6644104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker