Provider Demographics
NPI:1255576534
Name:GILLEN, AARON RENEE (DMFT, AMFT, CMT)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:RENEE
Last Name:GILLEN
Suffix:
Gender:F
Credentials:DMFT, AMFT, CMT
Other - Prefix:MISS
Other - First Name:AARON
Other - Middle Name:RENEE
Other - Last Name:HAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HHP/MASSAGE THERAPI
Mailing Address - Street 1:23809 SCARLET OAK DR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562
Mailing Address - Country:US
Mailing Address - Phone:760-638-2595
Mailing Address - Fax:
Practice Address - Street 1:721 N VULCAN AVE STE 211&213
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2190
Practice Address - Country:US
Practice Address - Phone:760-638-2595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2024-09-16
Deactivation Date:2022-05-17
Deactivation Code:
Reactivation Date:2024-09-16
Provider Licenses
StateLicense IDTaxonomies
CAAMFT144579405300000X, 106H00000X, 133NN1002X
WAMA60055729172M00000X
CACMT91063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No405300000XOther Service ProvidersPrevention Professional
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172M00000XOther Service ProvidersMechanotherapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist