Healthcare Provider Details

I. General information

NPI: 1952218208
Provider Name (Legal Business Name): CESILIA VEGA GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2221
LAGUNA HILLS CA
92654-2221
US

IV. Provider business mailing address

24001 CALLE DE LA MAGDALENA
LAGUNA HILLS CA
92654-1200
US

V. Phone/Fax

Practice location:
  • Phone: 949-416-9976
  • Fax:
Mailing address:
  • Phone: 949-416-9976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1429970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: