Individual provider Active NPI

Vides Apresto Santos

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange, CA
National Provider Identifier
1376216283
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95017592 Issued in CA
Practice address
2592 N Santiago Blvd Unit 100
Orange, CA 92867-1862
Phone
(855) 434-7763
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95017592 CA Primary

Addresses

Primary practice location

2592 N Santiago Blvd Unit 100
Orange, CA 92867-1862

Mailing address

20626 E Oak Crest Dr
Diamond Bar, CA 91765-4704
Phone (818) 741-6462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922002018 CA Practitioner - Nurse Practitioner 3971988239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thomas Health Services IncGroup PAC ID 1355748021, 32 clinicians

Practice addresses (Care Compare)

1500 Rosecrans Ave
Suite 500
Manhattan Beach, CA 90266-3771
Phone (310) 360-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95017592CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stephens Medical Corporation CurrentSince Mar 19, 2023 Accepting new patients
Thomas Health Services Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

320 Pine Ave
Ste 1030
Long Beach, CA 90802
Phone (310) 360-7200

11400 W Olympic Blvd
Ste 200
Los Angeles, CA 90064
Phone (401) 359-0757

1590 Rosecrans Ave
Ste D617
Manhattan Beach, CA 90266
Phone (310) 360-7200

1500 Rosecrans Ave
Ste 500
Manhattan Beach, CA 90266
Phone (310) 571-5936

402 W Broadway
Fl 4
San Diego, CA 92101

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1376216283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20626 E OAK CREST DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654704",
            "telephone_number": "818-741-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 N SANTIAGO BLVD UNIT 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928671862",
            "telephone_number": "855-434-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "VIDES",
        "middle_name": "APRESTO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95017592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.