Individual
MICHAEL VIGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2865 LOGAN AVE, SAN DIEGO, CA 92113-2411
(619) 232-4357
Mailing address
2865 LOGAN AVE, SAN DIEGO, CA 92113-2411
(619) 232-4357
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
16971
CA
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/05/2023
Last updated
10/22/2024
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