MEDICARE: MR. ROMERO JOSE AGUILAR LCSW

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	1041C0700X	Clinical Social Worker	LCSW61929	CA

General Provider Information

NPI Number	:	1427173087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROMERO JOSE AGUILAR LCSW

Provider Business Mailing Address
First Line	:	PO BOX 192
Second Line	:
City	:	PISMO BEACH
State	:	CA
Zip	:	93448-0192
Country	:	US
Telephone Number	:	805-210-1131
Fax Number	:	805-210-1131

Provider Business Practice Location Address
First Line	:	1303 E GRAND AVE
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-2460
Country	:	US
Telephone Number	:	805-210-1131
Fax Number	:

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	03/27/2026

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