Provider Demographics
NPI:1821393026
Name:VARGAS, NASTASSJA RACHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:NASTASSJA
Middle Name:RACHELLE
Last Name:VARGAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8775 AERO DR STE 238
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1756
Mailing Address - Country:US
Mailing Address - Phone:619-930-9524
Mailing Address - Fax:
Practice Address - Street 1:1101 UNION AVE # 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-1050
Practice Address - Country:US
Practice Address - Phone:661-631-1483
Practice Address - Fax:661-631-8665
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator