Provider Demographics
NPI:1073311007
Name:VARGA, VIVIENNE (LPA)
Entity type:Individual
Prefix:
First Name:VIVIENNE
Middle Name:
Last Name:VARGA
Suffix:
Gender:
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4867
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-4867
Mailing Address - Country:US
Mailing Address - Phone:970-977-9902
Mailing Address - Fax:
Practice Address - Street 1:25301 CABOT RD STE 216
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5512
Practice Address - Country:US
Practice Address - Phone:949-614-0098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program