Kodad, Vicki
Kodad, Vicki is an sole proprietor health care provider with primary practice located at 12712 Heacock St Suite 6, Moreno Valley CA 92553-3037. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Kodad, Vicki can be contacted via phone (951) 243-5576.Contact Information
Primary practice address
12712 Heacock St Suite 6
Moreno Valley CA 92553-3037
Phone: (951) 243-5576
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | CAADE051086 | California |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 101YM0800X | California |
Profile Details
| NPI number | 1023292158 |
|---|---|
| LBN Legal business name | Kodad, Vicki |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 26th, 2007 |
| Last updated | Jun 16th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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