Individual
GENESIS AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 1870, WATSONVILLE, CA 95077-1870
(831) 728-0222
Mailing address
PO BOX 1870, WATSONVILLE, CA 95077-1870
(831) 728-0222
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70832F
—
CA
05
—
HAP70832F
—
CA
01
—
ZZZ15685Z
MEDICARE GRP
CA
Enumeration date
08/30/2010
Last updated
05/24/2024
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