Provider Demographics
NPI:1952709685
Name:AGUILAR, DIANA (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 W AVENUE M14
Mailing Address - Street 2:STE P
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1443
Mailing Address - Country:US
Mailing Address - Phone:661-947-9554
Mailing Address - Fax:661-947-9337
Practice Address - Street 1:1007 W AVENUE M14
Practice Address - Street 2:STE P
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1443
Practice Address - Country:US
Practice Address - Phone:661-947-9554
Practice Address - Fax:661-947-9337
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-10313103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst