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General NPI Number Information
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NPI Number | 1801101399
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Entity Type | Individual
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Provider Name | DINANDREA VEGA LCSW, CSOTP
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Gender | Female
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 520 S GRAND AVE STE 680
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City | LOS ANGELES
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State | CA
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Zip | 90071-2655
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Country | US
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Telephone | 323-334-0277
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Fax |
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Provider Business Mailing Address
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Address Line | 116 S EL MOLINO AVE APT 8
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City | PASADENA
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State | CA
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Zip | 91101-2543
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Country | US
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Telephone | 323-641-1764
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904006595
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 70386
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License Number State | CA
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