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General NPI Number Information
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NPI Number | 1689067068
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Entity Type | Individual
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Provider Name | HILARIO VAZQUEZ MSW, CADC-II, PPSC
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Gender | Male
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 11934 HAWTHORNE BLVD UNIT A1
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City | HAWTHORNE
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State | CA
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Zip | 90250-3016
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Country | US
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Telephone | 424-269-0076
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Fax |
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Provider Business Mailing Address
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Address Line | 7044 TAMPA AVE
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City | RESEDA
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State | CA
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Zip | 91335-3715
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Country | US
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Telephone | 424-269-0076
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 108501
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License Number State | CA
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