MEDICARE: MRS. ANNA LILIA 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
1	106H00000X	Marriage & Family Therapist	51133	CA

General Provider Information

NPI Number	:	1306100102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA LILIA VARGAS LMFT

Provider Business Mailing Address
First Line	:	4624 ARLINGTON AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-2702
Country	:	US
Telephone Number	:	951-337-7310
Fax Number	:	951-697-9050

Provider Business Practice Location Address
First Line	:	4624 ARLINGTON AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-2702
Country	:	US
Telephone Number	:	951-337-7310
Fax Number	:	951-534-0642

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	02/09/2023

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