Basic Information
| Provider Information | |||||||||
| NPI: | 1184820474 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VARGAS-RICO | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1765 OLD GLEN ST | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920781069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7604738262 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2125 S EL CAMINO REAL STE 200 | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920546260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607305900 | ||||||||
| FaxNumber: | 7607305911 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2007 | ||||||||
| LastUpdateDate: | 03/15/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | LCS26402 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.