Edbajar Ramon Valdivieso, RVT, RDCS, BS

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

102917 Issued in CA

Practice address

1000 Newbury Rd Ste 270
Thousand Oaks, CA 91320-6445

Phone

(661) 309-5037

NPI assigned

Jul 18, 2023

Last updated

Aug 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

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

• Heart & Hypertension Health Medical Center, Inc.

  • Cardiovascular Disease Physician
  • Thousand Oaks, CA
  • NPI 1366567273
  NPD

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1205516937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913206435",
            "telephone_number": "661-309-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 270",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913206445",
            "telephone_number": "661-309-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDIVIESO",
        "first_name": "EDBAJAR",
        "middle_name": "RAMON",
        "credential": "RVT, RDCS, BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "CA",
            "license": "102917",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "102917",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "102917",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "102917",
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "CA",
            "license": "102917",
            "primary": false
        },
        {
            "code": "2471V0106X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular-Interventional Technology",
            "state": "CA",
            "license": "102917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sonography Radiologic Technologist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Sonography Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.