Individual
MIRELLY VARGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2560 N PERRIS BLVD STE N1, PERRIS, CA 92571-3251
(951) 940-6755
Mailing address
32675 MISSION TRL APT 9, LAKE ELSINORE, CA 92530-2326
(951) 413-4204
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-KXEVU
CA
Other
Enumeration date
01/31/2022
Last updated
07/12/2023
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