VIVID MED SPA, PROFESSIONAL CORPORATION
NPI 1619823036
Clinic/Center - Infusion Therapy in Ukiah, CA

Q: What is Vivid Med Spa, Professional Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Infusion Therapy, with taxonomy code 261QI0500X.

Active since March 09, 2026

166 E GOBBI ST, UKIAH, CA 95482(707) 414-0419 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Vivid Med Spa, Professional Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIVID MED SPA, PROFESSIONAL CORPORATION (NPI 1619823036), doing business as Vivid Med Spa & Laser Clinic, is a healthcare organization registered as an infusion therapy in Ukiah, California and active in the NPI registry since March 2026. The organization lists Ria Prakash Jivan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1619823036

Entity TypeOrganization

Primary Taxonomy261QI0500X

Legal Business NameVIVID MED SPA, PROFESSIONAL CORPORATION

Location Address166 E GOBBI STUkiah, CA 95482-4918

Mailing Address166 E Gobbi StUkiah, CA 95482-4918 · (707) 414-0419

Phone(707) 414-0419

Organization SubpartNo

Authorized OfficialRia Prakash JivanCeo · (903) 363-5914

Enumeration DateMarch 9, 2026

NPPES CertifiedMarch 8, 2026

✔ NPI 1619823036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Infusion TherapyAmbulatory Health Care Facilities

Taxonomy Code261QI0500X

Also ListedHome InfusionTaxonomy 251F00000X

Also ListedClinic/CenterTaxonomy 261Q00000X

Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X

Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X

166 E GOBBI ST, Ukiah, CA 95482

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Other Names 1

Doing Business AsVivid Med Spa & Laser Clinic

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vivid Med Spa, Professional Corporation's NPI number?

The NPI number for Vivid Med Spa, Professional Corporation is 1619823036. It was assigned to this organization in the NPPES registry on March 9, 2026. The provider is doing business as Vivid Med Spa & Laser Clinic.

Where is Vivid Med Spa, Professional Corporation located?

Vivid Med Spa, Professional Corporation is located at 166 E Gobbi St, Ukiah, CA 95482. The listed phone number is (707) 414-0419.

What is Vivid Med Spa, Professional Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Infusion Therapy, with taxonomy code 261QI0500X.

When was this NPI record last updated?

The NPPES record for Vivid Med Spa, Professional Corporation was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.