Provider Demographics
NPI:1225536493
Name:MUNIZ, VICKY
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VICKY
Other - Middle Name:
Other - Last Name:MUNIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3070 EUCALYPTUS AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1349
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3070 EUCALYPTUS AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1349
Practice Address - Country:US
Practice Address - Phone:562-822-7086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program