Provider Demographics
NPI:1073059770
Name:AGUILAR, MARIA
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:
Last Name:AGUILAR
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 1:12596 LEMON TREE RD
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-3547
Mailing Address - Country:US
Mailing Address - Phone:626-230-4610
Mailing Address - Fax:
Practice Address - Street 1:24021 ALESSANDRO BLVD STE 118
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-6710
Practice Address - Country:US
Practice Address - Phone:951-357-6926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-18
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician