Provider Demographics
NPI:1801527148
Name:VINLUAN, JUVIEL SANOPO
Entity type:Individual
Prefix:
First Name:JUVIEL
Middle Name:SANOPO
Last Name:VINLUAN
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 1:125 GARDENSIDE DR APT 306
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-3336
Mailing Address - Country:US
Mailing Address - Phone:661-860-5409
Mailing Address - Fax:
Practice Address - Street 1:1486 HUNTINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5971
Practice Address - Country:US
Practice Address - Phone:650-877-8642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist