Basic Information
| Provider Information | |||||||||
| NPI: | 1700903895 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGUILA | ||||||||
| FirstName: | GABRIELA | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5740 RALSTON ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930036571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052893383 | ||||||||
| FaxNumber: | 8052891676 | ||||||||
| Practice Location | |||||||||
| Address1: | 5740 RALSTON ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930036571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052893383 | ||||||||
| FaxNumber: | 8052891676 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2007 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 40865 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.