Healthcare Provider Details

I. General information

NPI: 1659036101
Provider Name (Legal Business Name): MISS TRINIDAD AGUILAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 W SHAW AVE # 107
FRESNO CA
93711-3229
US

IV. Provider business mailing address

3433 W SHAW AVE
FRESNO CA
93711-3229
US

V. Phone/Fax

Practice location:
  • Phone: 343-310-7937
  • Fax:
Mailing address:
  • Phone: 559-558-4051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: