Organization
VIDA MEDICAL OF DELAWARE PA
Active
Organization
VIDA MEDICAL OF DELAWARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE ODONNELL (DIRECTOR, QA AND COMPLIANCE)
(415) 989-1017
Entity
Organization
Contact information
Practice address
20500 BELSHAW AVE # EXCA1377, CARSON, CA 90746-3506
(415) 989-1017
Mailing address
20500 BELSHAW AVE # EXCA1377, CARSON, CA 90746-3506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
133V00000X
Registered Dietitian
—
—
171400000X
Health & Wellness Coach
—
—
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/29/2024
Last updated
07/21/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up