| Nastassjavargaslicensedclinicalsocialworker.inc | |
|
4075 Park Blvd Ste 102-156 San Diego CA 92103-2670 | |
| (619) 786-6402 | |
| Not Available |
| Full Name | Nastassjavargaslicensedclinicalsocialworker.inc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4075 Park Blvd Ste 102-156, San Diego, California |
| Authorized Official Name and Position | Nastassja Rachelle Vargas (OWNER/DIRECTOR) |
| Authorized Official Contact | 6197866402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nastassjavargaslicensedclinicalsocialworker.inc 4075 Park Blvd Ste 102-156 San Diego CA 92103-2670 Ph: (619) 786-6402 | Nastassjavargaslicensedclinicalsocialworker.inc 4075 Park Blvd Ste 102-156 San Diego CA 92103-2670 Ph: (619) 786-6402 |
| NPI Number | 1881278703 |
|---|---|
| Provider Enumeration Date | 05/06/2021 |
| Last Update Date | 05/06/2021 |
| Certification Date | 05/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881278703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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