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Individual

GLORIA AGUILAR BLANCEAGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
708 NOBEL DR UNIT C, SANTA CRUZ, CA 95060-2366
(831) 459-1818
Mailing address
708 NOBEL DR UNIT C, SANTA CRUZ, CA 95060-2366
(831) 459-1818

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
28250
CA

Other

Enumeration date
03/27/2017
Last updated
03/27/2017
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