MS. VIDA VICKERS (NPI# 1831493113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831493113 |
| Entity Type | Individual |
| Full Name | MS. VIDA VICKERS |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
2112 S Garey Ave Ste C Pomona CA 91766-5600 |
| Practice Telephone | 9094640520 |
| Practice Fax Number | 9094640523 |
| Mailing Telephone | 9094640520 |
| Mailing Fax Number | 9094640523 |
| Enumeration Date | 2010-12-31 |
| Last Update Date | 2010-12-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA20543 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2112 S GAREY AVE STE C |
| City | POMONA |
| State | CA |
| Zip Code | 91766-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962069393 | St John Community Health Center | Clinic/Center | 2112 S Garey Ave Ste C, Pomona, CA 91766-5600 | 2019-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851999494 | Justine Arce | Massage Therapist | 2063 Rancho Valley Drive Suite 320 #208, Pomona, CA 91766 | 2020-10-15 |
| 1699287938 | Monika Stephanie Wan | Pharmacist | 710 Rio Rancho Road, Pomona, CA 91766 | 2017-10-26 |
| 1306386966 | Teresa Le | Dentist | 1898 Wright St, Pomona, CA 91766 | 2017-03-02 |
| 1770971715 | Hanzel Mendez | Physical Therapist | 1080 Verbena Court, Pomona, CA 91766 | 2014-12-29 |
| 1902223589 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 3 Cottontail Dr, Pomona, CA 91766 | 2014-03-21 |
| 1487075578 | Fenix Health Medical Group, Inc. | Family Medicine | 716 East Mission Blvd., Pomona, CA 91766 | 2013-12-17 |
| 1134556012 | Imperial Hospice, Inc. | Hospice Care, Community Based | 363 S Park Ave Ste 105, Pomona, CA 91766 | 2013-10-08 |
| 1497196349 | Cohen Sedgh, Manavi & Pakravan Dental Corporation | Dentist | 763 Rio Rancho Road Suite120, Pomona, CA 91766 | 2013-07-08 |
| 1245573567 | Terry Chang | Acupuncturist | 3060 W. Temple Ave., Pomona, CA 91766 | 2013-04-04 |
| 1215271085 | Emmanuel Castro | Counselor | 4 Village Loop, Phillips Ranch, CA 91766 | 2012-11-19 |
| Find all providers in zip 91766 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760033278 | Kandin Maraquin | Physician Assistant | 1415 Ledgestone Ln, Pomona, CA 91767-3566 | 2019-09-25 |
| 1285123653 | Catherine Yaw | Physician Assistant | 450 E 2nd St, Pomona, CA 91766-1950 | 2018-05-01 |
| 1174052898 | Daniel Paul Bunker | Physician Assistant | 2410 N Towne Ave Unit 57, Pomona, CA 91767-2449 | 2017-06-06 |
| 1982074548 | Kathryn Taraneh Johnson | Physician Assistant | 1532 E. San Bernardino Ave, Suite A2, Pomona, CA 91762-4913 | 2015-09-25 |
| 1770982209 | Susan Kazumi Sasaki Pickard | Physician Assistant | 260 E. Holt Ave, Pomona, CA 91767 | 2014-08-20 |
| 1124337241 | Aracely Perales | Physician Assistant | 716 E. Mission Blvd, Suite D, Pomona, CA 91766 | 2010-10-07 |
| 1235372145 | Jane Ellen Rodgers | Physician Assistant | 790 E Bonita Ave Fl 2, Pomona, CA 91767-1906 | 2009-04-08 |
| 1275784852 | Reynaldo C Obrero | Physician Assistant | 502 S Garey Ave, Pomona, CA 91766-3319 | 2008-10-01 |
| 1487812293 | Avigayl Gordon | Physician Assistant | 3 Beaver Dam Rd, Pomona, NY 10970-3202 | 2008-05-29 |
| 1942366281 | Yoodiy A Gonzales | Physician Assistant | 822 N Garey Ave, Pomona, CA 91767-4616 | 2006-12-29 |
| Find all providers in POMONA | ||||
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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.