Provider Demographics
NPI:1922545912
Name:VARGAS CHILD & FAMILY COUNSELING
Entity Type:Organization
Organization Name:VARGAS CHILD & FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:209-497-2853
Mailing Address - Street 1:PO BOX 579668
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-9668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 SUNRISE AVE
Practice Address - Street 2:SUITE 7B
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4679
Practice Address - Country:US
Practice Address - Phone:209-497-2853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health