Doctor Name: | MISS SALLY AGUILAR |
NPI Number: | 1003193590 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA |
License Number: | N2496468 |
Business Practice Address: | 614 Tully Rd San Jose, CA - 951111048 |
Business Phone Number: | 4089771591 |
Business Fax Number: | 4089771136 |
Mailing Address: | 614 Tully Rd, SAN JOSE |
State: | CA |
Postal Code: | 951111048 |
Phone Number: | 4089771591 |
Fax Number: | 4089771136 |
NPI Enumeration Date: | 11/10/2011 |
NPI Last Update Date: | 11/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | N2496468 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |