Provider Demographics
NPI:1225710247
Name:VARGAS, CALLICO SUNSHINE (DSW, LSW,)
Entity Type:Individual
Prefix:DR
First Name:CALLICO
Middle Name:SUNSHINE
Last Name:VARGAS
Suffix:
Gender:F
Credentials:DSW, LSW,
Other - Prefix:
Other - First Name:CALLICO
Other - Middle Name:SUNSHINE
Other - Last Name:NEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:445 W MANGRUM DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81007-1890
Mailing Address - Country:US
Mailing Address - Phone:720-340-6016
Mailing Address - Fax:
Practice Address - Street 1:445 W MANGRUM DR
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81007-1890
Practice Address - Country:US
Practice Address - Phone:720-340-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009921630104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker