Provider Demographics
NPI:1194886572
Name:AGUILERA-RIOS, ALBA
Entity type:Individual
Prefix:MISS
First Name:ALBA
Middle Name:
Last Name:AGUILERA-RIOS
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 1:1292 PAGE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3064
Mailing Address - Country:US
Mailing Address - Phone:415-621-2929
Mailing Address - Fax:415-621-4758
Practice Address - Street 1:1292 PAGE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3064
Practice Address - Country:US
Practice Address - Phone:415-621-2929
Practice Address - Fax:415-621-4758
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 47527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health