Provider Demographics
NPI:1851538714
Name:VIESCA, VERONICA PATRICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:PATRICIA
Last Name:VIESCA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:PATRICIA
Other - Last Name:KUHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1621 LA PLAYA AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-6473
Mailing Address - Country:US
Mailing Address - Phone:619-746-0669
Mailing Address - Fax:
Practice Address - Street 1:5005 TEXAS ST STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3722
Practice Address - Country:US
Practice Address - Phone:619-376-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203022106H00000X
CA80308106H00000X
WA61238453106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist