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NPI Code Detail

MEDICARE: MS. RITA DREADEN

MEDICARE: MS. RITA DREADEN
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
1163W00000XRegistered Nurse238207CA
2363L00000XNurse Practitioner1203CA

General Provider Information

NPI Number : 1144365891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RITA DREADEN
Provider Business Mailing Address
First Line : P.O. BOX 11867
Second Line : CORRECTIONAL HEALTH DIVISION
City : FRESNO
State : CA
Zip : 93775-1867
Country : US
Telephone Number : 559-445-3246
Fax Number : 559-445-3370
Provider Business Practice Location Address
First Line : 1310 M ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1808
Country : US
Telephone Number : 559-264-2700
Fax Number : 559-264-2767
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 12/20/2018

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