Provider Demographics
NPI:1801282942
Name:VARGAS, KATHRYN REBECCA (MD, PHD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:REBECCA
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18218 N 53RD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-7641
Mailing Address - Country:US
Mailing Address - Phone:480-323-0961
Mailing Address - Fax:985-243-9558
Practice Address - Street 1:16420 N 92ND ST STE 222
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1949
Practice Address - Country:US
Practice Address - Phone:480-321-6246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ519312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry