Provider Demographics
NPI:1013408236
Name:VARGAS, NORMA EVANGELINA (LMFT)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:EVANGELINA
Last Name:VARGAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 E CARSON PLAZA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3271
Mailing Address - Country:US
Mailing Address - Phone:310-523-9500
Mailing Address - Fax:310-225-2725
Practice Address - Street 1:460 E CARSON PLAZA DR STE 100
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746
Practice Address - Country:US
Practice Address - Phone:310-523-9500
Practice Address - Fax:310-225-2725
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAAMFT98357101YM0800X
CALMFT114918106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health