Provider Demographics
NPI:1386796449
Name:AGUINIGA, DELORES (LCSW)
Entity type:Individual
Prefix:MS
First Name:DELORES
Middle Name:
Last Name:AGUINIGA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 WILLOW AVE
Mailing Address - Street 2:STE. 102
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-4746
Mailing Address - Country:US
Mailing Address - Phone:559-999-5542
Mailing Address - Fax:559-291-5229
Practice Address - Street 1:3128 WILLOW AVE
Practice Address - Street 2:STE. 102
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-4746
Practice Address - Country:US
Practice Address - Phone:559-999-5542
Practice Address - Fax:559-291-5229
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 103071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ021862Medicare ID - Type UnspecifiedLICENSED CLINICAL SOCIAL