Vividerm Wound Care

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

VIVIDERM WOUND CARE

Practice address

4081 Pomelo Dr
Corona, CA 92883-3697

Phone

(714) 417-4452

NPI assigned

Mar 6, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Sophia P Ho, DONPI 1790245256

Title

Medical Director

Phone

(714) 417-4452

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sophia Phuong Ho, DO

  • Internal Medicine Physician
  • Corona, CA
  • NPI 1790245256
  Medicare reassignment NPD Authorized official
• Aprilyn Calderon, NP

  • Nurse Practitioner
  • Buena Park, CA
  • NPI 1528807385
  Medicare reassignment NPD
• Jennifer Dagdag Flor

  • Nurse Practitioner
  • Anaheim, CA
  • NPI 1720829195
  Medicare reassignment NPD
• Jovelyn Urdaneta Galo, AGNP

  • Gerontology Nurse Practitioner
  • Riverside, CA
  • NPI 1821830761
  Medicare reassignment NPD
• Fatima Ramos Huynh, FNP-C

  • Nurse Practitioner
  • Irvine, CA
  • NPI 1477133668
  Medicare reassignment NPD
• Ann Marielle Reyes Reyes, NP

  • Nurse Practitioner
  • Cerritos, CA
  • NPI 1790520765
  Medicare reassignment NPD
• Ava Septe T Salarda, N.P.

  • Gerontology Nurse Practitioner
  • Harbor City, CA
  • NPI 1225307804
  Medicare reassignment NPD

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745107200000",
    "number": "1407654189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4081 POMELO DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928833697",
            "telephone_number": "714-417-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4081 POMELO DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928833697",
            "telephone_number": "714-417-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIDERM WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-04-20",
        "certification_date": "2025-04-20",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-417-4452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vista Cove Care Center at Corona, Inc.
• Denise Mendoza Vite
• Reema Vithlani, RN
• Sarah Jane Vitug, MD, MPHIL
• Vanesa Vivanco
• Viz Eye Care Optometry, Inc, a Professional Corp
• Maria Vizcarra
• Nhan Hong Vo
• Lena Maria Volland, DPT
• Jennifer Vong, DO

• In Home Supportive Care Agency in Corona, CA
• Providers in Corona, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.