Provider Demographics
NPI:1336420181
Name:VARGAS, VERONICA MICHELLE
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:MICHELLE
Last Name:VARGAS
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 1:4237 COLLIS AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-1007
Mailing Address - Country:US
Mailing Address - Phone:323-376-6161
Mailing Address - Fax:
Practice Address - Street 1:155 N OCCIDENTAL BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-4641
Practice Address - Country:US
Practice Address - Phone:213-381-2931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor