MEDICARE: PETRA AGUIRRE

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		CA

General Provider Information

NPI Number	:	1790827731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETRA AGUIRRE

Provider Business Mailing Address
First Line	:	631 S BROOKHURST ST UNIT 104
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3510
Country	:	US
Telephone Number	:	714-620-8131
Fax Number	:	714-620-8132

Provider Business Practice Location Address
First Line	:	631 S BROOKHURST ST UNIT 104
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3510
Country	:	US
Telephone Number	:	714-620-8131
Fax Number	:	714-620-8132

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	02/21/2024

Similar Medicare Providers

1588260350 — KELVIN LE-BUI
Practice Location Address:

631 S BROOKHURST ST
ANAHEIM, CA
92804-3510

Practice Phone: 714-620-8131
Practice Fax:

1992725154 — MS. ROXANE MARIE BERENBEIM OTR/R, RN
Practice Location Address:

631 S BROOKHURST ST , #106
ANAHEIM, CA
92804-3510

Practice Phone: 714-490-7711
Practice Fax:

1316967276 — MR. MICHAEL RAY WILLIAMS BS, CADC
Practice Location Address:

631 S BROOKHURST ST , SUITE 106
ANAHEIM, CA
92804-3510

Practice Phone: 714-490-7711
Practice Fax: 714-490-7717

1841335692 — COLLEGE COMMUNITY SERVICES
Practice Location Address:

631 S BROOKHURST ST STE 104
ANAHEIM, CA
92804-3510

Practice Phone: 714-620-8131
Practice Fax: 714-620-8132

1811182884 — JENNIFER JOYCE JACKSON BA
Practice Location Address:

631 S BROOKHURST ST , SUITE 106
ANAHEIM, CA
92804-3510

Practice Phone: 714-490-7711
Practice Fax: 714-490-7717

1245557974 — JODY ANN VIZCAY
Practice Location Address:

631 S BROOKHURST ST STE 104
ANAHEIM, CA
92804-3510

Practice Phone: 714-620-8131
Practice Fax:

Directions to “ PETRA AGUIRRE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.