Provider Demographics
NPI:1568353340
Name:VARGAS, SANDRA SOLEDAD
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:SOLEDAD
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 1:11724 E PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85132-7614
Mailing Address - Country:US
Mailing Address - Phone:602-478-7680
Mailing Address - Fax:
Practice Address - Street 1:2066 W APACHE TRL
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-3733
Practice Address - Country:US
Practice Address - Phone:928-366-9495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health