Provider Demographics
NPI:1326523796
Name:VARGAS, SONYA DENISE (CMT)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:DENISE
Last Name:VARGAS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 SYDNEY WAY APT 205
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-5121
Mailing Address - Country:US
Mailing Address - Phone:619-517-7748
Mailing Address - Fax:
Practice Address - Street 1:250 E GRAND AVE # G
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2803
Practice Address - Country:US
Practice Address - Phone:442-777-3255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92638225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty