Provider Demographics
NPI:1063191179
Name:AGUILERA SANCHEZ, DARIANA
Entity type:Individual
Prefix:
First Name:DARIANA
Middle Name:
Last Name:AGUILERA SANCHEZ
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 1:2964 TAOS DR
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92509-2133
Mailing Address - Country:US
Mailing Address - Phone:909-928-6580
Mailing Address - Fax:
Practice Address - Street 1:1316 S COAST HWY
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-3118
Practice Address - Country:US
Practice Address - Phone:949-313-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA705375164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse