Individual
VIVIANA NIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 W BRIGGSMORE AVE STE I, MODESTO, CA 95350-3839
(209) 526-1476
Mailing address
2000 W BRIGGSMORE AVE STE I, MODESTO, CA 95350-3839
(209) 526-1476
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
117227
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2018
Last updated
09/06/2023
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