Misty Van Vliet

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

141232 Issued in CA

Practice address

2000 W Briggsmore Ave Ste I
Modesto, CA 95350-3839

Phone

(209) 526-1476

NPI assigned

Jul 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1962136259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W BRIGGSMORE AVE STE I",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503839",
            "telephone_number": "209-526-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BRIGGSMORE AVE STE I",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503839",
            "telephone_number": "209-526-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VLIET",
        "first_name": "MISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "141232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Joy Van Klaveren, DPT
• Isabel Doan Van Sicklen
• Jimmy Dean Van Tassel, LCSW
• Jessica Nicole Van Tuinen
• Katie Van Vliet, NTP
• Annah Van Vuren
• Arianna Van Winkle
• Martine Vancol Telcy
• Mara Vande Pol
• Lorese Gerlone Gomes Vandemark, DDS

• Professional Counselor in Modesto, CA
• Providers in Modesto, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.