Provider Demographics
NPI:1114645371
Name:VARAY, ANA EUGENIA (PHD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:EUGENIA
Last Name:VARAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45111 FERN AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2301
Mailing Address - Country:US
Mailing Address - Phone:661-949-1205
Mailing Address - Fax:
Practice Address - Street 1:45111 FERN AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2301
Practice Address - Country:US
Practice Address - Phone:661-949-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist