Provider Demographics
NPI:1265885487
Name:AGUIRRE, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:AGUIRRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 W MATILIJA ST
Mailing Address - Street 2:B
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2586
Mailing Address - Country:US
Mailing Address - Phone:805-451-7373
Mailing Address - Fax:
Practice Address - Street 1:2291 PORTOLA RD
Practice Address - Street 2:A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7724
Practice Address - Country:US
Practice Address - Phone:805-451-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01-167052OtherBOARD CERTIFIED ASSISTANT BEHAVIOR ANALYST