Provider Demographics
NPI:1043699267
Name:VARGAS, YOLANDA
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
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 1:10130 E AVENUE S4
Mailing Address - Street 2:
Mailing Address - City:LITTLEROCK
Mailing Address - State:CA
Mailing Address - Zip Code:93543-2014
Mailing Address - Country:US
Mailing Address - Phone:818-371-0010
Mailing Address - Fax:
Practice Address - Street 1:11565 LAUREL CANYON BLVD.
Practice Address - Street 2:SUITE 116
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345
Practice Address - Country:US
Practice Address - Phone:818-361-5030
Practice Address - Fax:818-361-1764
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner