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General NPI Number Information
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NPI Number | 1265820575
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Entity Type | Individual
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Provider Name | DEBORAH NEVAREZ-VIVOLO
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Gender | Female
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Dates
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Enumeration Date | 01/08/2015
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 21125 CENTRE POINTE PKWY
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City | SANTA CLARITA
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State | CA
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Zip | 91350-2994
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Country | US
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Telephone | 855-435-3801
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Fax |
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Provider Business Mailing Address
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Address Line | 14890 JEREMIE ST
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City | BALDWIN PARK
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State | CA
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Zip | 91706-5628
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Country | US
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Telephone | 626-485-0424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 122545
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License Number State | CA
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