# OPTVIDA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740041748
- **Authorized official:** CANDACE ANN JAMES PMHNP-BC (OWNER)
- **Authorized official phone:** (435) 553-5915

## Contact information

- **Practice address:** 1034 RSI DR UNIT 120, LOGAN, UT 84321-2203
- **Practice address phone:** (435) 704-9342
- **Practice address fax:** (435) 355-3874
- **Mailing address:** 98 E 500 S, PROVIDENCE, UT 84332-9801
- **Mailing address phone:** (435) 553-5915

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2024
- **Last updated:** 01/17/2024