Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1134376791 |
---|---|
Provider Name | Dr. Renee Maria Aguilar |
First Address | San Carlos, CA 94070-4151 |
Second Address | San Carlos, CA 94070-4151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 24/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
95-2633765 | MEDICAL (01) | CA |