Provider Demographics
NPI:1790935740
Name:VARGAS, LIZBETH
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:
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 1:4996 LA SIERRA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-2612
Mailing Address - Country:US
Mailing Address - Phone:951-525-3752
Mailing Address - Fax:
Practice Address - Street 1:2275 S MAIN ST STE BAND201
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5303
Practice Address - Country:US
Practice Address - Phone:951-279-3222
Practice Address - Fax:951-279-5222
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist