Provider Demographics
NPI:1043886583
Name:DEL AGUILA, MARJORIE B
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:B
Last Name:DEL AGUILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 W LANCASTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2543
Mailing Address - Country:US
Mailing Address - Phone:661-729-2321
Mailing Address - Fax:
Practice Address - Street 1:6040 W AVENUE L
Practice Address - Street 2:
Practice Address - City:QUARTZ HILL
Practice Address - State:CA
Practice Address - Zip Code:93536-4501
Practice Address - Country:US
Practice Address - Phone:661-718-3100
Practice Address - Fax:661-943-8203
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN306798163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool