Basic Information
| Provider Information | |||||||||
| NPI: | 1669017182 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAZARES | ||||||||
| FirstName: | AURORA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12 | ||||||||
| Address2: | |||||||||
| City: | YOLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956970012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308672057 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 W BEAMER ST | ||||||||
| Address2: | |||||||||
| City: | WOODLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956952510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304052800 | ||||||||
| FaxNumber: | 5302045255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2019 | ||||||||
| LastUpdateDate: | 07/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | APCC8067 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | APC1293 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | APCC8067 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.