Provider Demographics
NPI:1245883594
Name:ARANDA, VIVIAN C (RADT)
Entity type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:C
Last Name:ARANDA
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4617 ZANE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-2039
Mailing Address - Country:US
Mailing Address - Phone:323-392-9573
Mailing Address - Fax:
Practice Address - Street 1:4617 ZANE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-2039
Practice Address - Country:US
Practice Address - Phone:323-392-9573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility