Helena Joann Vipond, M.D.

Individual provider Active NPI General Practice Physician · Smith River, CA

NPI 1023239191 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1023239191
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
G19585 (CA)
Practice address
415 Highland Avenue
Smith River, CA 95567
Phone
(707) 487-3405
Fax
(707) 487-3405
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G19585 CA Yes

Addresses

Primary practice location

415 Highland Avenue
Smith River, CA 95567

Mailing address

415 Highland Avenue
Smith River, CA 95567
Phone (707) 487-3405

Other identifiers

IdentifierTypeStateIssuer
9304725MedicaidCA

Other providers in Smith River, CA

All providers in Smith River, CA · General Practice Physician in California

Sources for this page

Verify at the official NPI Registry.