Active NPI
Carlos A. Vidales, PHD
- Psychologist
- Burbank, CA
National Provider Identifier
1891634309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 36673
- Practice address
- 500 E Olive Ave Ste 540
Burbank, CA 91501-2132 - Phone
- (818) 446-2522
- NPI assigned
- Mar 27, 2026
- Last updated
- Mar 27, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 36673 | CA | Primary |
Addresses
Primary practice location
500 E Olive Ave Ste 540
Burbank, CA 91501-2132
Mailing address
1425 S Leland Ave
West Covina, CA 91790-2434
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
- Clinical Psychologist
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
500 E Olive Ave
Suite 540
Burbank, CA 91501-2132
Phone (818) 446-2238
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36673 | CA | MD | Psychologist |
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.
-
- Psychologist
- Burbank, CA
- NPI 1710370895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774569600000",
"number": "1891634309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 S LELAND AVE",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E OLIVE AVE STE 540",
"city": "BURBANK",
"state": "CA",
"postal_code": "915012132",
"telephone_number": "818-446-2522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDALES",
"first_name": "CARLOS",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-03-27",
"last_updated": "2026-03-27",
"certification_date": "2026-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "36673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.