Provider Demographics
NPI:1144718883
Name:AGUILAR,, DANIEL (COTA/L)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:AGUILAR,
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10108 SUMMER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3618
Mailing Address - Country:US
Mailing Address - Phone:562-201-5538
Mailing Address - Fax:
Practice Address - Street 1:10108 SUMMER AVE
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3618
Practice Address - Country:US
Practice Address - Phone:562-201-5538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3988224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant