1700601580 NPI number — MRS. SUSANA DEL ROCIO VARGAS CARACAS DOULA

Table of content: MRS. SUSANA DEL ROCIO VARGAS CARACAS DOULA (NPI 1700601580)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700601580 NPI number — MRS. SUSANA DEL ROCIO VARGAS CARACAS DOULA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VARGAS CARACAS
Provider First Name:
SUSANA
Provider Middle Name:
DEL ROCIO
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DOULA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARACAS
Provider Other First Name:
SUSY
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DOULA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1700601580
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
133 CORNELL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-829-5563
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 CORNELL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-829-5563
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/18/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 374J00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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