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Ivy Glaze Vidad
NPI 1700393428 · Behavior Technician · Stockton, CA
Ivy Glaze Vidad is a Behavior Technician provider in Stockton, CA (NPI 1700393428).
Provider details
- NPI number
- 1700393428
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1212345 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2453 Grand Canal Blvd Ste a
Stockton, CA 95207-8259
Phone: (855) 223-7123
Street-level locationGet directions
Mailing address
16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Registry dates
- Enumerated
- 2018-01-03
- Last updated
- 2021-08-19
- Certified
- 2021-08-19
Frequently asked questions
- What is Ivy Glaze Vidad's NPI number?
- Ivy Glaze Vidad's National Provider Identifier (NPI) is 1700393428, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ivy Glaze Vidad's specialty?
- Ivy Glaze Vidad is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Ivy Glaze Vidad located?
- Ivy Glaze Vidad's practice location on file with NPPES is 2453 Grand Canal Blvd Ste a, Stockton, CA 95207-8259.
- What is Ivy Glaze Vidad's phone number?
- The practice phone number listed in the NPPES registry for Ivy Glaze Vidad is (855) 223-7123.
- Is Ivy Glaze Vidad's NPI active?
- Yes — Ivy Glaze Vidad's NPI (1700393428) is active in the NPPES registry as of the last update on 2021-08-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.