Healthcare Provider Details

I. General information

NPI: 1861897670
Provider Name (Legal Business Name): ALEXANDRO GARCIA VARGAS PH.D., MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 S CENTRAL ST
VISALIA CA
93277-4522
US

IV. Provider business mailing address

1810 S CENTRAL ST
VISALIA CA
93277-4522
US

V. Phone/Fax

Practice location:
  • Phone: 559-635-4252
  • Fax:
Mailing address:
  • Phone: 559-635-4252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: