MEDICARE: ALEXIS AQUILES

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1689538043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS AQUILES

Provider Business Mailing Address
First Line	:	16380 ROSCOE BLVD STE 100
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-1221
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3409
Country	:	US
Telephone Number	:	833-227-3454
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ ALEXIS AQUILES ” Practice Location

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