Healthcare Provider Details

I. General information

NPI: 1982072427
Provider Name (Legal Business Name): VLADA BIDLAUSKAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2015
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45124 10TH ST W
LANCASTER CA
93534-2310
US

IV. Provider business mailing address

550 S VERMONT AVE STE 601
LOS ANGELES CA
90020-1912
US

V. Phone/Fax

Practice location:
  • Phone: 866-733-5924
  • Fax:
Mailing address:
  • Phone: 213-351-7284
  • Fax: 213-042-7616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039681
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95071641
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number271208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: