MEDICARE: KRISTIN RICE

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	1041C0700X	Clinical Social Worker	1302952	OR

General Provider Information

NPI Number	:	1093901670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN RICE

Provider Business Mailing Address
First Line	:	7410 MISSION VALLEY RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4405
Country	:	US
Telephone Number	:	619-497-8982
Fax Number	:

Provider Business Practice Location Address
First Line	:	7410 MISSION VALLEY RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4405
Country	:	US
Telephone Number	:	619-497-8982
Fax Number	:

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

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	02/10/2015

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Directions to “ KRISTIN RICE ” Practice Location

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