Ismael Vidrio II, SUDRC #18885

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

18885 Issued in CA

Practice address

13106 Woodridge Ave
La Mirada, CA 90638-1755

Phone

(562) 455-5251

NPI assigned

Aug 12, 2024

Last updated

Aug 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1730910696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13106 WOODRIDGE AVE",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381755",
            "telephone_number": "562-455-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13106 WOODRIDGE AVE",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381755",
            "telephone_number": "562-455-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRIO",
        "first_name": "ISMAEL",
        "name_suffix": "II",
        "credential": "SUDRC #18885",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "18885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Elizabeth Vanhemelryck
• Xavier G Velasco, DC
• Ninoska Velo
• Rafael Enrico Victoria, L.C.S.W.
• Luis Antonio Vidaurrazaga Jr.
• Manjusha Vinjamury
• Vista Specialty Hospital of California, LLC
• Gilberto Viteri
• Alexander Arceo Vizcarra, D.M.D.
• Qui Vu, M.D.

• Addiction (Substance Use Disorder) Counselor in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.