Provider Demographics
NPI:1124156682
Name:AGUILAR, BETTY ANN
Entity type:Individual
Prefix:MS
First Name:BETTY
Middle Name:ANN
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 1:2150 STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1337
Mailing Address - Country:US
Mailing Address - Phone:916-875-1016
Mailing Address - Fax:916-854-9462
Practice Address - Street 1:2150 STOCKTON BLVD
Practice Address - Street 2:LINX
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-876-5600
Practice Address - Fax:916-876-5615
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator