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General NPI Number Information
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NPI Number | 1497143119
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Entity Type | Individual
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Provider Name | ROSALBA AGUILERA LONGORIA
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Gender | Female
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 1612 FIRST STREET
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City | COACHELLA
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State | CA
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Zip | 92236
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Country | US
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Telephone | 760-398-9000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3715
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City | CATHEDRAL CITY
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State | CA
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Zip | 92235-3715
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Country | US
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Telephone | 760-427-7415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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