Individual
MS. NIVIA VIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNP
Contact information
Practice address
11911 CENTRAL AVE, CHINO, CA 91710-1906
(909) 631-2435
(909) 631-2462
Mailing address
11911 CENTRAL AVE, CHINO, CA 91710-1906
(909) 631-2435
(909) 631-2462
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
NP13219
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP13219
NP LICENSE
CA
Enumeration date
03/18/2013
Last updated
03/18/2013
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