MEDICARE: STEPHANIE AGUILAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	Y2117825	CA

General Provider Information

NPI Number	:	1346813607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE AGUILAR

Provider Business Mailing Address
First Line	:	5910 1/2 QUINN ST
Second Line	:
City	:	BELL GARDENS
State	:	CA
Zip	:	90201-6627
Country	:	US
Telephone Number	:	562-735-9747
Fax Number	:

Provider Business Practice Location Address
First Line	:	5910 1/2 QUINN ST
Second Line	:
City	:	BELL GARDENS
State	:	CA
Zip	:	90201-6627
Country	:	US
Telephone Number	:	562-735-9747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	07/22/2021

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Directions to “ STEPHANIE AGUILAR ” Practice Location

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