Basic Information
| Provider Information | |||||||||
| NPI: | 1093332413 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIRON | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | NOEMY | ||||||||
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| Credential: | MS, PCC, PPS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7940 RESEDA BLVD APT 121 | ||||||||
| Address2: | |||||||||
| City: | RESEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913351976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189413302 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16360 ROSCOE BLVD FL 2 | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914061219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189014830 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2020 | ||||||||
| LastUpdateDate: | 09/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.