DR. DESIRAE NICOLLE VIDAURRI (NPI# 1073041026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073041026 |
| Entity Type | Individual |
| Full Name | DR. DESIRAE NICOLLE VIDAURRI |
| Other Name | MS. DESRIAE NICOLLE BOLDT |
| Credential | PHD |
| Practice Address |
2400 Canal St New Orleans LA 70119-6535 |
| Mailing Address |
144 Elk Pl Apt 1507 New Orleans LA 70112-2636 |
| Practice Telephone | 5045072000 |
| Mailing Telephone | 5125388051 |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2017-06-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810005697 | VA | Behavioral Health & Social Service Providers |
| Street Address |
2400 CANAL ST |
| City | NEW ORLEANS |
| State | LA |
| Zip Code | 70119-6535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487612081 | New Orleans Vamc | Department of Veterans Affairs (VA) Pharmacy | 2400 Canal St, New Orleans, LA 70119-6535 | 2006-05-03 |
| 1013515253 | Charles Major | Perfusionist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-10-10 |
| 1659988673 | Jeremy Lawrence Hamm I | Occupational Therapist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-09-24 |
| 1750997359 | Rachel Ashworth West | Physical Therapist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-09-18 |
| 1891301495 | Katie Graffeo Dimm | Physical Therapist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-09-18 |
| 1912513557 | Theresa Montelepre Connick | Occupational Therapist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-09-18 |
| 1922614528 | Damaris La Santa-nieves | Physical Therapist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-09-18 |
| 1942816541 | Amy Charlotte Gillies | Occupational Therapist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-09-18 |
| 1023624640 | Steven B Johnson | Physical Therapist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-09-18 |
| 1306452198 | Melody Anne Vilardo | Physical Therapist | 2400 Canal St, New Orleans, LA 70119-6535 | 2020-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161105 | Mark P Kostelak | Perfusionist | Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119 | 2020-10-15 |
| 1922626365 | Shanika Valcour-leduff | Nurse Practitioner | 535 S Galvez St., New Orleans, LA 70119 | 2020-07-13 |
| 1932723335 | Just Health | Clinic/Center | 2800 Perdido St, New Orleans, LA 70119 | 2020-06-01 |
| 1205460235 | Lily Tran | Registered Nurse | 119 S Galvez Street, New Orleans, LA 70119 | 2020-02-28 |
| 1740823137 | Kaylyn Bernard | Case Manager/Care Coordinator | 2626 Canal St., New Orleans, LA 70119 | 2019-10-18 |
| 1114577954 | Alyssia Breion Smith | Case Manager/Care Coordinator | 1995 Gentilly Blvd. Ste. C-400, New Orleans, LA 70119 | 2019-09-13 |
| 1457903387 | Brian Steven Goldfarb | Dentist | 3701 Conti St, Apt #3403, New Orleans, LA 70119 | 2019-07-11 |
| 1013404011 | Made Positive, Inc. | Community/Behavioral Health | 3443 Esplanade Ave., Suite 215, New Orleans, LA 70119 | 2018-04-16 |
| 1972008654 | Griffin Caballero Brown | Student in an Organized Health Care Education/Training Program | 520 Jefferson Davis Hwy, New Orleans, LA 70119 | 2018-03-26 |
| 1902300544 | Kyle Raymond Hoppens | Student in an Organized Health Care Education/Training Program | 4502 Saint Ann Street, New Orleans, LA 70119 | 2018-03-20 |
| Find all providers in zip 70119 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497378848 | Lifesource of North Carolina | Psychologist | 8315 Zimpel St, New Orleans, LA 70118-1169 | 2020-05-20 |
| 1396397816 | Eileen Marie Palace | Psychologist | 2820 Napoleon Ave Ste 340, New Orleans, LA 70115-6977 | 2019-07-15 |
| 1356906812 | Jinaki Flint | Psychologist | 7934 Edinburgh Street, New Orleans, LA 70125 | 2019-05-09 |
| 1518452036 | Leigh Miller | Psychologist | 7611 Maple St Ste A2, New Orleans, LA 70118-5068 | 2018-06-27 |
| 1407395411 | Center for Resilience Inc | Psychologist | 2603 Baronne St, New Orleans, LA 70113 | 2017-02-23 |
| 1992256200 | Rebecca Anne Elliott Smith | Psychologist | 2738 General Pershing Street, New Orleans, LA 70115 | 2016-10-21 |
| 1780131185 | The Color Gallery, Inc. | Psychologist | 2220 Oretha Castle Haley Blvd, New Orleans, LA 70113-1508 | 2016-09-02 |
| 1568812832 | Kelly Bolger | Psychologist | 3517 Camp St, 1/2, New Orleans, LA 70115-2535 | 2016-06-17 |
| 1568833242 | Brian Lamar Turner | Psychologist | 2105 Arts St, New Orleans, LA 70117-7611 | 2015-10-07 |
| 1740667146 | Jared Ian Israel | Psychologist | Brent House, 1514 Jefferson Highway, New Orleans, LA 70121 | 2015-05-05 |
| Find all providers in NEW ORLEANS | ||||
| City | NEW ORLEANS |
| Zip Code | 70119 |
Please comment or provide details below to improve the information on DR. DESIRAE NICOLLE VIDAURRI.
| 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.