Provider Demographics
NPI:1457196040
Name:AGUILAR, KAELA (PT, DPT)
Entity type:Individual
Prefix:
First Name:KAELA
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5270 EDGAR ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-9126
Mailing Address - Country:US
Mailing Address - Phone:858-752-0984
Mailing Address - Fax:
Practice Address - Street 1:2051 STATHAM BLVD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3901
Practice Address - Country:US
Practice Address - Phone:805-765-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist