Provider Demographics
NPI:1033691589
Name:VARGAS, LILIANA DORENA
Entity Type:Individual
Prefix:MRS
First Name:LILIANA
Middle Name:DORENA
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 1:5240 MERTOLA DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-7566
Mailing Address - Country:US
Mailing Address - Phone:916-990-8091
Mailing Address - Fax:
Practice Address - Street 1:5240 MERTOLA DR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-7566
Practice Address - Country:US
Practice Address - Phone:916-990-8091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist