Basic Information
| Provider Information | |||||||||
| NPI: | 1093286247 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGUIRRE | ||||||||
| FirstName: | SESIAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 940 AVENUE 64 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911052711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232542274 | ||||||||
| FaxNumber: | 3239781263 | ||||||||
| Practice Location | |||||||||
| Address1: | 4927 HUNTINGTON DR N STE 200 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900321679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232210779 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2018 | ||||||||
| LastUpdateDate: | 02/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | AMFT104449 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YP2500X | APCC10952 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.