Provider Demographics
NPI:1467180877
Name:AGUIRRE, BRENDA ALICIA (MSW)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:ALICIA
Last Name:AGUIRRE
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12877 1/2 PIERCE ST APT 119
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-2525
Mailing Address - Country:US
Mailing Address - Phone:818-233-3081
Mailing Address - Fax:
Practice Address - Street 1:11565 LAUREL CANYON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4649
Practice Address - Country:US
Practice Address - Phone:818-901-4830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW123330104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker