Provider Demographics
NPI:1598110488
Name:MUNGUIA, AURA M
Entity type:Individual
Prefix:
First Name:AURA
Middle Name:M
Last Name:MUNGUIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AURA
Other - Middle Name:M
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:911 N BUFFALO DR
Mailing Address - Street 2:SUITE 213
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0379
Mailing Address - Country:US
Mailing Address - Phone:702-942-1774
Mailing Address - Fax:
Practice Address - Street 1:4820 BUSINESS CENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1907
Practice Address - Country:US
Practice Address - Phone:707-703-5075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1274341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV145600645Medicaid