MEDICARE: JUDY T RIPALDA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN29192	NV
2	163WM0705X	Medical-Surgical Registered Nurse	495273	CA

General Provider Information

NPI Number	:	1003196064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY T RIPALDA RN

Provider Business Mailing Address
First Line	:	6670 GLADE AVE
Second Line	:	APT# 103
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91303-2541
Country	:	US
Telephone Number	:	818-521-5860
Fax Number	:	747-444-9271

Provider Business Practice Location Address
First Line	:	6670 GLADE AVE
Second Line	:	APT# 103
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91303-2541
Country	:	US
Telephone Number	:	818-521-5860
Fax Number	:	747-444-9271

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2011
Last Update Date	:	08/23/2011

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