Individual
KIMBERLY AGUILAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
360 MAMALA BAY DR, JBPHH, HI 96853-1801
(808) 447-1590
Mailing address
445 KAILUA RD APT 5101, KAILUA, HI 96734-2921
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126002918
VA
2255A2300X
Athletic Trainer
Primary
AT-374
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000026367
BOARD OF CERTIFICATION
—
01
—
AT-374
STATE LICENSE
HI
Enumeration date
01/08/2018
Last updated
08/16/2021
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