Provider Demographics
NPI:1073825212
Name:VARGAS, SANDIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SANDIA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 CASA LINDA AVE SUITE 101
Mailing Address - Street 2:CARR 177 LOS FILTROS KM 2.0
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-789-1989
Mailing Address - Fax:787-764-7358
Practice Address - Street 1:1 CASA LINDA AVE SUITE 101
Practice Address - Street 2:CARR 177 LOS FILTROS KM 2.0
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-789-1989
Practice Address - Fax:787-764-7358
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-03
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3825103TA0400X, 103TF0000X, 103TH0004X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth