Vida Counseling Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LMFT86942 Issued in CA

Legal business name

VIDA COUNSELING SERVICES

Practice address

2900 Adams St Ste B30-16
Riverside, CA 92504-8311

Phone

(951) 220-8607

Fax

(951) 220-8607

NPI assigned

Mar 8, 2018

Last updated

Mar 8, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Luis Resendez Jr., M.A.

Title

Owner

Phone

(951) 220-8607

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520467200000",
    "number": "1033612783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 ADAMS ST STE B30-16",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925048311",
            "telephone_number": "951-220-8607",
            "fax_number": "951-220-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 ADAMS ST STE B30-16",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925048311",
            "telephone_number": "951-220-8607",
            "fax_number": "951-220-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A",
        "authorized_official_last_name": "RESENDEZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-220-8607",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LMFT86942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Riverside, CA
• Providers in Riverside, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.