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Individual
ELIZABETH RYAN VIDOVICH
Active
Individual
ELIZABETH RYAN VIDOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
CA
164W00000X
Licensed Practical Nurse
Primary
VN230370
CA
167G00000X
Licensed Psychiatric Technician
VN203070
CA
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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