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NPI Code Detail

MEDICARE: MRS. DIANE SARA VARGAS LMFT

MEDICARE: MRS. DIANE SARA VARGAS LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist51511CA

General Provider Information

NPI Number : 1093929341
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANE SARA VARGAS LMFT
Provider Business Mailing Address
First Line : 1907 BOYS REPUBLIC DR
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-5447
Country : US
Telephone Number : 909-628-1217
Fax Number : 909-306-5427
Provider Business Practice Location Address
First Line : 1907 BOYS REPUBLIC DR
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-5447
Country : US
Telephone Number : 909-628-1217
Fax Number : 909-306-5427
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 06/16/2022

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