Provider Demographics
NPI:1184316135
Name:AGUILAR COTA, ENRIQUE (MS, ABAT)
Entity type:Individual
Prefix:MR
First Name:ENRIQUE
Middle Name:
Last Name:AGUILAR COTA
Suffix:
Gender:M
Credentials:MS, ABAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1592 SMYTHE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-1564
Mailing Address - Country:US
Mailing Address - Phone:619-205-2757
Mailing Address - Fax:
Practice Address - Street 1:1592 SMYTHE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92173-1564
Practice Address - Country:US
Practice Address - Phone:619-205-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst