Active NPI
Vides Apresto Santos
- Psychiatric/Mental Health Nurse Practitioner
- Orange, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95017592
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 95017592 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephens Medical Corporation | Current | Accepting new patients | |
| Thomas Health Services Inc | Current | 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.
-
- Psychiatry Physician
- Long Beach, CA
- NPI 1659972099
-
- Psychiatry Physician
- Long Beach, CA
- NPI 1235839002
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.