Provider Demographics
NPI:1154932309
Name:CHARO, AURORA DIAZ
Entity type:Individual
Prefix:MS
First Name:AURORA
Middle Name:DIAZ
Last Name:CHARO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:AURORA
Other - Middle Name:TINAJERO
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:571 SPENCER LN STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-2030
Mailing Address - Country:US
Mailing Address - Phone:210-736-4405
Mailing Address - Fax:210-736-4407
Practice Address - Street 1:571 SPENCER LN STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-2030
Practice Address - Country:US
Practice Address - Phone:210-736-4405
Practice Address - Fax:210-736-4407
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11364101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)