Prizila Dajia Vidal, MPSS-LIADFM

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

415 Laurel St PMB 531
San Diego, CA 92101

Phone

(619) 755-4737

NPI assigned

Sep 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1598988180
  NPD (past)
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780099200000",
    "number": "1043795164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 LAUREL ST PMB 531",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011605",
            "telephone_number": "619-755-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 LAUREL ST PMB 531",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92101",
            "telephone_number": "619-755-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "PRIZILA",
        "middle_name": "DAJIA",
        "credential": "MPSS-LIADFM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2026-05-30",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-LIADFM",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": "DB365140CB",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "23070",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "CA",
            "license": "7506073033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vida Hospice Southern California Inc.
• Hadembes James Vida Malik
• Leandro Aaron Vidal
• Logan Robert Vidal, DO
• Martha Karina Vidal
• Marc M Vidale, IDC
• Michelle Vidana, LPCC
• Monica Mae Vidaurrazaga, MD
• Kathrine Vidaurri
• Kathya Vides, RN

• Contractor in San Diego, CA
• Providers in San Diego, CA by specialty
• Contractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2026; 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.