Individual
VANESSA VIDALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
137 N COTTONWOOD ST STE 1500, WOODLAND, CA 95695-6646
(530) 666-8630
Mailing address
137 N COTTONWOOD ST STE 1500, WOODLAND, CA 95695-6646
(530) 666-8630
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-XBSRHL
CA
Other
Enumeration date
12/09/2024
Last updated
12/23/2024
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