Provider Demographics
NPI:1205946282
Name:AGUIRRE, WENDY (ASW)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9445 FARNHAM ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1399
Mailing Address - Country:US
Mailing Address - Phone:619-279-1961
Mailing Address - Fax:619-220-0437
Practice Address - Street 1:9445 FARNHAM ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1399
Practice Address - Country:US
Practice Address - Phone:619-279-1961
Practice Address - Fax:619-220-0437
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 1041C0700X
CA74219101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical