Healthcare Provider Details

I. General information

NPI: 1043488612
Provider Name (Legal Business Name): SONIA VAQUERA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 WEST CECIL AVENUE
DELANO CA
93215
US

IV. Provider business mailing address

2912 ASHBY ST
BAKERSFIELD CA
93308-1433
US

V. Phone/Fax

Practice location:
  • Phone: 661-721-2345
  • Fax:
Mailing address:
  • Phone: 661-721-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22366
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: