Provider Demographics
NPI:1861253106
Name:AGUILAR, HELDAI (CPT1)
Entity type:Individual
Prefix:
First Name:HELDAI
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:CPT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 BONI SUE CT
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:CA
Mailing Address - Zip Code:95953-2086
Mailing Address - Country:US
Mailing Address - Phone:530-649-7945
Mailing Address - Fax:
Practice Address - Street 1:451 PARKFAIR DR STE 3
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-7249
Practice Address - Country:US
Practice Address - Phone:530-649-7945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT-02124440246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty