Provider Demographics
NPI:1174157481
Name:VARGA, KASEY LYN (MFT)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:LYN
Last Name:VARGA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1197 VALENCIA ST STE 6
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3026
Mailing Address - Country:US
Mailing Address - Phone:415-203-2793
Mailing Address - Fax:
Practice Address - Street 1:1197 VALENCIA ST STE 6
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3026
Practice Address - Country:US
Practice Address - Phone:415-203-2793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC51150101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health