Provider Demographics
NPI:1184756231
Name:ARAGON, PERLA MARISOL
Entity type:Individual
Prefix:
First Name:PERLA
Middle Name:MARISOL
Last Name:ARAGON
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 1:20151 NORDHOFF ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-6215
Mailing Address - Country:US
Mailing Address - Phone:213-259-6124
Mailing Address - Fax:
Practice Address - Street 1:20151 NORDHOFF ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-6215
Practice Address - Country:US
Practice Address - Phone:213-259-6124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CALCSW1000941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAENK1896OtherLA DEPT OF MENTAL HEALTH