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NPI Code Detail

MEDICARE: STEPHANIE A AGUAYO

MEDICARE: STEPHANIE A AGUAYO
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1184150955
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE A AGUAYO
Provider Business Mailing Address
First Line : 316 S ELLIOTT AVE
Second Line :
City : AZUSA
State : CA
Zip : 91702-4942
Country : US
Telephone Number : 626-378-7739
Fax Number :
Provider Business Practice Location Address
First Line : 14148 MAGNOLIA BLVD STE 103
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91423-6414
Country : US
Telephone Number : 818-933-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 11/03/2022

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Directions to “ STEPHANIE A AGUAYO ” Practice Location

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