Provider Demographics
NPI:1740408061
Name:VANG, MAY BAO
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:BAO
Last Name:VANG
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 1:6802 SAVAGE CT
Mailing Address - Street 2:2359 ULRIC STREET
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6025
Mailing Address - Country:US
Mailing Address - Phone:858-268-4933
Mailing Address - Fax:858-268-0244
Practice Address - Street 1:2359 ULRIC ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6402
Practice Address - Country:US
Practice Address - Phone:858-268-4933
Practice Address - Fax:858-268-0244
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health