Provider Demographics
NPI:1144088964
Name:WATSON, VIKKI KAYE
Entity type:Individual
Prefix:MS
First Name:VIKKI
Middle Name:KAYE
Last Name:WATSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14210 S VERMONT AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-2271
Mailing Address - Country:US
Mailing Address - Phone:310-756-9303
Mailing Address - Fax:
Practice Address - Street 1:14210 S VERMONT AVE APT 102
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-2271
Practice Address - Country:US
Practice Address - Phone:310-756-9303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker