Provider Demographics
NPI:1174335699
Name:VEGA, ALICIA PEREZ-URIBE
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:PEREZ-URIBE
Last Name:VEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:PEREZ URIBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:FIDDLETOWN
Mailing Address - State:CA
Mailing Address - Zip Code:95629-0216
Mailing Address - Country:US
Mailing Address - Phone:209-304-3019
Mailing Address - Fax:
Practice Address - Street 1:450 S MILL ST
Practice Address - Street 2:
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640-9141
Practice Address - Country:US
Practice Address - Phone:209-257-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter