Provider Demographics
NPI:1922410778
Name:ARAULLO, VIVIAN
Entity Type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:
Last Name:ARAULLO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:ZALVIDEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:957 INDUSTRIAL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-4151
Mailing Address - Country:US
Mailing Address - Phone:415-725-1165
Mailing Address - Fax:
Practice Address - Street 1:957 INDUSTRIAL RD
Practice Address - Street 2:SUITE B
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-4151
Practice Address - Country:US
Practice Address - Phone:415-725-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-1186168OtherMEDI-CAL