MEDICARE: DR. VERONICA PATRICIA VIESCA PHD

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	203022	TX
2	106H00000X	Marriage & Family Therapist	80308	CA
3	106H00000X	Marriage & Family Therapist	61238453	WA

General Provider Information

NPI Number	:	1851538714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERONICA PATRICIA VIESCA PHD

Provider Business Mailing Address
First Line	:	1621 LA PLAYA AVE APT 24
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-6473
Country	:	US
Telephone Number	:	619-746-0669
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 TEXAS ST STE 106
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3722
Country	:	US
Telephone Number	:	619-376-3311
Fax Number	:

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

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	07/29/2024

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