# ELIZABETH RYAN VIDOVICH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1033543731
- **Gender:** F
- **Credential:** LVN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | CA | — |
| 164W00000X | Licensed Practical Nurse | VN230370 | CA | Yes |
| 167G00000X | Licensed Psychiatric Technician | VN203070 | CA | — |

## Other

- **Enumeration date:** 08/29/2013
- **Last updated:** 08/29/2013