Individual
AVA GWIN-AGUILERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
14566 SEVENTH ST, VICTORVILLE, CA 92395-4214
(760) 843-0895
(760) 843-0894
Mailing address
24 HAMMOND STE C, IRVINE, CA 92618-1680
(949) 770-6022
(949) 770-7084
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 410
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410
OT LICENSE
CA
Enumeration date
12/29/2006
Last updated
11/07/2007
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