PRIZILA DAJIA VIDAL (NPI# 1043795164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043795164 |
| Entity Type | Individual |
| Full Name | PRIZILA DAJIA VIDAL |
| Practice Address |
1045 9th Ave San Diego CA 92101-5504 |
| Mailing Address |
1045 9th Ave # Ace San Diego CA 92101-5504 |
| Practice Telephone | 6192352600 |
| Practice Fax Number | 6196969573 |
| Mailing Telephone | 6192352600 |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1045 9TH AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92101-5504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538237359 | Linda Carter | Registered Nurse | 1045 9th Ave, San Diego, CA 92101-5504 | 2006-12-01 |
| 1144834300 | Lauren Michelle Norris | Registered Nurse | 1045 9th Ave, San Diego, CA 92101-5504 | 2020-09-04 |
| 1033731757 | Christina Zamarro | Registered Nurse | 1045 9th Ave, San Diego, CA 92101-5504 | 2020-05-15 |
| 1013545805 | Andre Wilson | Registered Nurse | 1045 9th Ave, San Diego, CA 92101-5504 | 2020-03-29 |
| 1619503034 | Lacie Sommer | Registered Nurse | 1045 9th Ave, San Diego, CA 92101-5504 | 2020-03-17 |
| 1437785169 | Kerry Rogers | Counselor | 1045 9th Ave, San Diego, CA 92101-5504 | 2020-03-13 |
| 1043844020 | Anette Ruiz | Marriage & Family Therapist | 1045 9th Ave, San Diego, CA 92101-5504 | 2020-02-27 |
| 1316584410 | Bre'aja Bruce | Registered Nurse | 1045 9th Ave, San Diego, CA 92101-5504 | 2019-12-08 |
| 1093357022 | Marilia Rodriguez | Registered Nurse | 1045 9th Ave, San Diego, CA 92101-5504 | 2019-10-10 |
| 1205486677 | Leslie Amaya, Amft | Marriage & Family Therapist | 1045 9th Ave, San Diego, CA 92101-5504 | 2019-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415472 | Ryanleo Flores | Nurse Practitioner | 2017 1st Avenue, Suite 301, San Diego, CA 92101 | 2020-10-18 |
| 1265056048 | Tilbe Yildirim | Student in an Organized Health Care Education/Training Program | 1963 Fourth Ave., San Diego, CA 92101 | 2020-06-08 |
| 1235752585 | Liminal Solutions LLC | Home Health | 845 15th Street, Floors 1-4, San Diego, CA 92101 | 2020-05-21 |
| 1699258459 | Talya Donahue | Peer Specialist | 1045 Ninth Ave, San Diego, CA 92101 | 2018-09-07 |
| 1700380086 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1850 5th Ave, San Diego, CA 92101 | 2018-03-21 |
| 1013436161 | Yasmin Galicianava | Student in an Organized Health Care Education/Training Program | 734 Tenth Ave, San Diego, CA 92101 | 2017-09-10 |
| 1487172516 | Jessica Roach | Counselor | 1045 9th Avenue, San Diego, CA 92101 | 2017-09-09 |
| 1699204099 | Lisa Nunez | Student in an Organized Health Care Education/Training Program | 1963 4th Avenue, San Diego, CA 92101 | 2017-06-08 |
| 1356882245 | Dajah Mone't Lockett | Counselor | 2535 Kettner Blvd Suite 1a4, San Diego, CA 92101 | 2017-03-13 |
| 1649718495 | Luigi Bunyi | Behavior Technician | 501 W Broadway Suite 800, San Diego, CA 92101 | 2017-02-01 |
| Find all providers in zip 92101 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043826753 | Dayjahnay Shantay Davenport | Peer Specialist | 3347 Lincoln Ave, San Diego, CA 92104-2111 | 2020-09-17 |
| 1427683101 | Gerardo Castro | Peer Specialist | 5555 Reservoir Dr # 204-a, San Diego, CA 92120-5134 | 2020-03-03 |
| 1487298840 | Garrett Ives | Peer Specialist | 2909 Keats St Apt 7, San Diego, CA 92106-2345 | 2019-10-29 |
| 1144882622 | Melissa Ratsamy | Peer Specialist | 286 Euclid Ave Project Enable, #102, San Diego, CA 92114 | 2019-07-03 |
| 1699258459 | Talya Donahue | Peer Specialist | 1045 Ninth Ave, San Diego, CA 92101 | 2018-09-07 |
| 1811434467 | Deborah Sue Lynn | Peer Specialist | 140 W. Arbor Dr., Ucsd Gifford Outpatient Clinic, San Diego, CA 92103-2421 | 2017-01-20 |
| 1023463163 | Miguel Pablo Surposa | Peer Specialist | 5711 Bolivar St, San Diego, CA 92139-1617 | 2016-04-26 |
| 1376140590 | Leon Samuel Mancilla | Peer Specialist | 5555 Reservoir Dr, San Diego, CA 92120-5134 | 2020-10-01 |
| 1982210092 | Nicole Lynn Iwan | Peer Specialist | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2020-09-23 |
| 1962014001 | Paulina Alvarado | Peer Specialist | 6160 Mission Gorge Rd, San Diego, CA 92120-3410 | 2020-08-19 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.