VIVIDLIFE KETAMINE CLINIC
NPI 1992575682
Clinic/Center - Health Service in Concord, CA
About Vividlife Ketamine Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VIVIDLIFE KETAMINE CLINIC (NPI 1992575682) is a healthcare organization registered as a health service in Concord, California and active in the NPI registry since January 2024. The organization lists Be-verlyn Navarro, Np, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vividlife Ketamine Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Vividlife Ketamine Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Vividlife Ketamine Clinic's NPI number?
The NPI number for Vividlife Ketamine Clinic is 1992575682. It was assigned to this organization in the NPPES registry on January 4, 2024.
Where is Vividlife Ketamine Clinic located?
Vividlife Ketamine Clinic is located at 5167 Clayton Rd Ste H, Concord, CA 94521. The listed phone number is (323) 336-1178.
What is Vividlife Ketamine Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.
Is Vividlife Ketamine Clinic enrolled in Medicare?
Yes. Vividlife Ketamine Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Vividlife Ketamine Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Vividlife Ketamine Clinic, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Vividlife Ketamine Clinic was last updated on April 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Vividlife Ketamine Clinic · NPI 1992575682
Health Service organization in Concord, California. Organization record, active in the CMS NPPES registry since January 4, 2024.
## Identity
- **NPI:** 1992575682 (Entity type: Organization)
- **Enumerated:** January 4, 2024
- **Primary specialty:** Clinic/Center - Health Service · taxonomy 261QH0100X
- **Organization subpart:** No
- **Authorized official:** Be-Verlyn Navarro, NP
## Practice location
- **Address:** 5167 CLAYTON RD STE H, Concord, CA 94521-3170
- **Phone:** (323) 336-1178
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1992575682) · Data from the CMS NPPES public registry.