Provider Demographics
NPI:1588486203
Name:AGUILUZ, DENISE Y
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:Y
Last Name:AGUILUZ
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 1:1026 S BONNIE BEACH PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-2535
Mailing Address - Country:US
Mailing Address - Phone:323-819-7476
Mailing Address - Fax:
Practice Address - Street 1:22750 HAWTHORNE BLVD STE 229
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3670
Practice Address - Country:US
Practice Address - Phone:828-998-4521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health