Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043699267 |
---|---|
Provider Name | Yolanda Vargas |
First Address | Littlerock, CA 93543-2014 |
Second Address | Mission Hills, CA 91345 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2015 |
Last Update Date | 02/06/2015 |