Pamela Doreen Vidato, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12784 Issued in CA

Practice address

40700 California Oaks Rd Ste 202
Murrieta, CA 92562-5789

Phone

(951) 894-5072

Fax

(714) 542-2246

NPI assigned

Jan 25, 2008

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• P Doreen Vidato Jordan Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

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  NPD (past)
• WCHS, Inc

  dba Bellingham Treatment Solutions

  • Methadone Clinic
  • Bellingham, WA
  • NPI 1811592116
  NPD (past)

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1790962306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40700 CALIFORNIA OAKS RD STE 202",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625789",
            "telephone_number": "951-894-5072",
            "fax_number": "714-542-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40700 CALIFORNIA OAKS RD STE 202",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625789",
            "telephone_number": "951-894-5072",
            "fax_number": "714-542-2246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2275 E Cooley Dr",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923246324",
            "country_code": "US",
            "telephone_number": "951-370-1777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 W La Cadena Dr",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925011413",
            "country_code": "US",
            "telephone_number": "951-784-8010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDATO",
        "first_name": "PAMELA DOREEN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MURRIETA",
            "affiliation": "N",
            "address_1": "40700 California Oaks Rd",
            "city": "Murrieta",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925625795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "P DOREEN",
            "last_name": "VIDATO JORDAN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Verio Healthcare, Inc
• Vesper Psychiatry
• Veteran Six
• Robert Veve, MD
• Cederick Jason Victor, LCSW
• Reed Andrew Vierra, PSY.D.
• Joana Villa
• Dexter Villanueva, RPT
• Ma. Cristina Villanueva, PTA
• Robert Villanueva, NP

• Physician Assistant in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.