Individual
DR. AURELIO ENRIQUEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, PSYD
Contact information
Practice address
9330 BASELINE RD STE 108, RANCHO CUCAMONGA, CA 91701-5827
(909) 980-1000
(866) 880-1254
Mailing address
9330 BASELINE RD STE 108, RANCHO CUCAMONGA, CA 91701-5827
(909) 980-1000
(866) 880-1254
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-29785
CA
1041C0700X
Clinical Social Worker
LCS 24862
CA
Other
Enumeration date
03/20/2007
Last updated
03/27/2018
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