Provider Demographics
NPI:1417105032
Name:VARGAS, MARIA JUDITH
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JUDITH
Last Name:VARGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 CHAMPLAIN DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2754
Mailing Address - Country:US
Mailing Address - Phone:909-624-3981
Mailing Address - Fax:
Practice Address - Street 1:415 CHAMPLAIN DR
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2754
Practice Address - Country:US
Practice Address - Phone:909-624-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker