Provider Demographics
NPI:1952083081
Name:AGUILAR, AURORA E
Entity type:Individual
Prefix:
First Name:AURORA
Middle Name:E
Last Name:AGUILAR
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 1:636 ADAMS ST APT 2
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3251
Mailing Address - Country:US
Mailing Address - Phone:408-832-6413
Mailing Address - Fax:
Practice Address - Street 1:215 W BEAMER ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2510
Practice Address - Country:US
Practice Address - Phone:530-405-2892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1542210124101YA0400X
CA149790106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)