Healthcare Provider Details

I. General information

NPI: 1306332028
Provider Name (Legal Business Name): LUIS EFREN AGUILAR PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W LIME AVE STE 101
MONROVIA CA
91016-2841
US

IV. Provider business mailing address

118 W LIME AVE STE 101
MONROVIA CA
91016-2841
US

V. Phone/Fax

Practice location:
  • Phone: 626-321-2889
  • Fax:
Mailing address:
  • Phone: 626-321-2889
  • Fax: 626-593-4199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY34659
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: