Prizila Dajia Vidal, MPSS-LIADFM is a
Contractor based in San Diego, California. Prizila Dajia Vidal is licensed to practice in * (Not Available) (license number ) and her current practice location is
415 Laurel St Pmb 531, San Diego, California. She can be reached at her office (for appointments etc.) via phone at
(619) 755-4737.
NPI number for Prizila Dajia Vidal is 1043795164 and her current mailing address is 415 Laurel St Pmb 531, San Diego, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1043795164.
Healthcare Provider's Profile
| Full Name | Prizila Dajia Vidal |
|---|
| Gender | Female |
|---|
| Speciality | Contractor |
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| Location | 415 Laurel St Pmb 531, San Diego, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1043795164
- Provider Enumeration Date: 09/25/2018
- Last Update Date: 09/15/2024
Medical Identifiers
Medical identifiers for Prizila Dajia Vidal such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043795164 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 24-QMHS-I-0008 (California) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
| 175T00000X | Peer Specialist | (California) | Secondary |
| 175T00000X | Peer Specialist | MPSS-LIADFM (California) | Secondary |
| 171W00000X | Contractor | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Prizila Dajia Vidal is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Prizila Dajia Vidal, MPSS-LIADFM
415 Laurel St Pmb 531,
San Diego, CA 92101
Ph: (619) 755-4737 | Prizila Dajia Vidal, MPSS-LIADFM
415 Laurel St Pmb 531,
San Diego, CA 92101
Ph: (619) 755-4737 |
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