Doctor Name: | VALERIE C RIDGEWAY |
NPI Number: | 1093917122 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 5660 |
Business Practice Address: | 165 Rowland Way Suite 311 Novato, CA - 949455038 |
Business Phone Number: | 4158979664 |
Business Fax Number: | 4158972446 |
Mailing Address: | 2938 Mark West Station Rd, WINDSOR |
State: | CA |
Postal Code: | 954927607 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5660 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |