Provider Demographics
NPI:1215157870
Name:VERGARA, FRANCISCA MARIA (MSW)
Entity type:Individual
Prefix:
First Name:FRANCISCA
Middle Name:MARIA
Last Name:VERGARA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 DEL NORTE RD
Mailing Address - Street 2:#130 INTERFACE CHILDREN FAMILY SERVICES
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010
Mailing Address - Country:US
Mailing Address - Phone:805-485-6114
Mailing Address - Fax:805-278-4391
Practice Address - Street 1:1305 DEL NORTE RD
Practice Address - Street 2:#130 INTERFACE CHILDREN FAMILY SERVICES
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010
Practice Address - Country:US
Practice Address - Phone:805-485-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
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