Individual
CARLOS JR. VARGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
540 S EREMLAND DR, COVINA, CA 91723-3186
(626) 966-1577
Mailing address
15645 MONICA CT, FONTANA, CA 92336-8739
(909) 997-4651
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
9877-R
CA
101YP2500X
Professional Counselor
Primary
APCC10705
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/23/2017
Last updated
01/11/2022
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