Provider Demographics
NPI:1265017024
Name:VEGA, ALINA (LMFT)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28303 ALTON WAY
Mailing Address - Street 2:
Mailing Address - City:CASTAIC
Mailing Address - State:CA
Mailing Address - Zip Code:91384-3820
Mailing Address - Country:US
Mailing Address - Phone:323-552-6555
Mailing Address - Fax:
Practice Address - Street 1:28303 ALTON WAY
Practice Address - Street 2:
Practice Address - City:CASTAIC
Practice Address - State:CA
Practice Address - Zip Code:91384-3820
Practice Address - Country:US
Practice Address - Phone:323-552-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-13
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2152106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist