Individual
JOYCELYN VIDAL
Active
Individual
JOYCELYN VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
594657
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
13163
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN5946570
MEDICAL
CA
Enumeration date
10/11/2006
Last updated
05/08/2012
Update your record
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