Active NPI
Daisy Vidrio
- Professional Counselor
- Riverside, CA
National Provider Identifier
1619544582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8631
- Practice address
- 9685 Hayes Street
Riverside, CA 92503-9250 - Phone
- (951) 351-4418
- NPI assigned
- Jun 8, 2021
- Last updated
- Dec 1, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 8631 | CA | Primary |
Addresses
Primary practice location
9685 Hayes Street
Riverside, CA 92503-9250
Mailing address
9685 Hayes Street
Riverside, CA 92503-2049
Phone (951) 351-4418
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
402 W Broadway
Suite 400
San Diego, CA 92101-3554
PO Box
Suite 8208
Moreno Valley, CA 92552-8208
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
dba Cyti Psychological
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San Diego, CA
- NPI 1679172290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1619544582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9685 HAYES STREET",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925032049",
"telephone_number": "951-351-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9685 HAYES STREET",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925039250",
"telephone_number": "951-351-4418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDRIO",
"first_name": "DAISY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-08",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "8631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.