Provider Demographics
NPI:1972758993
Name:AGUILAR, ANTHONY (LMFT)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:653 HUTCHISON ST
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-1411
Mailing Address - Country:US
Mailing Address - Phone:760-224-6132
Mailing Address - Fax:
Practice Address - Street 1:707 CIVIC CENTER DR
Practice Address - Street 2:SUITE 106
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-6160
Practice Address - Country:US
Practice Address - Phone:760-224-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC29400OtherLICENSED MARRAIGE/FAMILY THERAPIST