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

Vidian Anastasya Pangalila

Individual provider Licensed Psychiatric Technician · NPI 1033092564

Vidian Anastasya Pangalila is a Licensed Psychiatric Technician in Colton, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025

Practice location Address checks out

400 N Pepper Ave
Colton, CA 92324-1819
Phone: (909) 580-1800
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Psychiatric Technician (primary) Taxonomy 167G00000X · Licence 42954 (CA)

Record details

NPI number1033092564
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedJuly 30, 2025
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025

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