Basic Information
| Provider Information | |||||||||
| NPI: | 1265927990 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGUILAR | ||||||||
| FirstName: | ADRIANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 S THORSON AVE | ||||||||
| Address2: | |||||||||
| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902213563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234744403 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20101 HAMILTON AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905021351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105277300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2018 | ||||||||
| LastUpdateDate: | 06/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.