# VVID LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** VVID LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598519357
- **Authorized official:** JOSEPHINE HARTS NP (OWNER)
- **Authorized official phone:** (707) 567-1674

## Contact information

- **Practice address:** 191 SAND CREEK RD \# CA230, BRENTWOOD, CA 94513-2215
- **Practice address phone:** (925) 663-8158
- **Mailing address:** PO BOX 786, BETHEL ISLAND, CA 94511-0786

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/16/2024
- **Last updated:** 10/10/2024