Provider Demographics
NPI:1548723372
Name:AGUILAR, SONIA MONIQUE (CNA, PCA,MEDTECH,HHA)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:MONIQUE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:CNA, PCA,MEDTECH,HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 KEARSAGE DR # F230
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86406-9086
Mailing Address - Country:US
Mailing Address - Phone:928-706-7582
Mailing Address - Fax:
Practice Address - Street 1:3140 KEARSAGE DR # F230
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86406-9086
Practice Address - Country:US
Practice Address - Phone:928-706-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3747P1801X, 374U00000X
AZCNA1000043657376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ..OtherHEART TO HEART