MEDICARE: ARIANA VILLARREAL-AGUINIGA

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1215463864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANA VILLARREAL-AGUINIGA

Provider Business Mailing Address
First Line	:	2496 S MOUNTAINSIDE DR
Second Line	:
City	:	LOS BANOS
State	:	CA
Zip	:	93635-8804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2496 S MOUNTAINSIDE DR
Second Line	:
City	:	LOS BANOS
State	:	CA
Zip	:	93635-8804
Country	:	US
Telephone Number	:	209-489-4679
Fax Number	:

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

Provider Enumeration Date	:	05/02/2017
Last Update Date	:	05/02/2017

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