Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Vida Medical, New Jersey, PC Nj

Organization Counselor · NPI 1265208052

Vida Medical, New Jersey, PC Nj is a Counselor in San Francisco, California. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
9
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

100 Montgomery St Ste 750
San Francisco, CA 94104-4302
Phone: (845) 721-6214
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Counselor Taxonomy 101Y00000X
Psychologist Taxonomy 103T00000X
Social Worker Taxonomy 104100000X
Registered Dietitian Taxonomy 133V00000X
Health & Wellness Coach Taxonomy 171400000X
Family Medicine Physician Taxonomy 207Q00000X
Clinic/Center Taxonomy 261Q00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1265208052
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacqueline Odonnell — Sr. Manager, Compliance · (845) 721-6214
NPI enumeratedDecember 1, 2023
Last updated in NPPESJuly 21, 2024
Certification dateJuly 21, 2024
Mailing address100 Montgomery St Ste 750, San Francisco, CA 94104-4302

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