Provider Demographics
NPI:1023344504
Name:DINEROS, MARIA VARGAS (LPT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:VARGAS
Last Name:DINEROS
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 MURAL ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-6366
Mailing Address - Country:US
Mailing Address - Phone:760-434-2183
Mailing Address - Fax:760-434-2111
Practice Address - Street 1:659 MURAL ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-6366
Practice Address - Country:US
Practice Address - Phone:760-434-2183
Practice Address - Fax:760-434-2111
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPT26336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health