Provider Demographics
NPI:1235370149
Name:VEGA, ALBERTO JR
Entity Type:Individual
Prefix:MR
First Name:ALBERTO
Middle Name:
Last Name:VEGA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 E MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-5224
Mailing Address - Country:US
Mailing Address - Phone:619-441-1907
Mailing Address - Fax:619-441-1908
Practice Address - Street 1:1625 E MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5224
Practice Address - Country:US
Practice Address - Phone:619-441-1907
Practice Address - Fax:619-441-1908
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health