Provider Demographics
NPI:1801908470
Name:VANG, PA K (MS)
Entity type:Individual
Prefix:
First Name:PA
Middle Name:K
Last Name:VANG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3331 POWER INN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3889
Mailing Address - Country:US
Mailing Address - Phone:916-874-6015
Mailing Address - Fax:
Practice Address - Street 1:3321 POWER INN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3890
Practice Address - Country:US
Practice Address - Phone:916-874-6015
Practice Address - Fax:916-874-4639
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA50788106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist