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General NPI Number Information
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NPI Number | 1316862790
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Entity Type | Organization
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Legal Business Name | VIDA PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 18430 BROOKHURST ST STE 201G
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6757
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Country | US
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Telephone | 949-591-9508
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Fax | 949-861-9816
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Provider Business Mailing Address
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Address Line | 18430 BROOKHURST ST STE 201G
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6757
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Country | US
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Telephone | 949-591-9508
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Fax | 949-861-9816
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Authorized Official
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Title or Position | OWNER
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Name | LAURA MARISOL ZAMORA MACIAS
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Credential | PSYD., LMFT
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Telephone | 949-664-3218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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