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Individual
SARA ANDREA VIDES
Active
Individual
SARA ANDREA VIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC III
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1336760219
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
22337
CA
Other
Enumeration date
02/11/2019
Last updated
04/21/2026
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