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NPI Code Detail

MEDICARE: TESSA RITCHIE

MEDICARE: TESSA RITCHIE
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
1390200000XStudent in an Organized Health Care Education/Training Program
2101YM0800XMental Health Counselor6250CA

General Provider Information

NPI Number : 1518397819
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESSA RITCHIE
Provider Business Mailing Address
First Line : 4455 ESTRELLA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92115-4627
Country : US
Telephone Number : 760-310-6733
Fax Number :
Provider Business Practice Location Address
First Line : 5252 BALBOA AVE STE 408
Second Line :
City : SAN DIEGO
State : CA
Zip : 92117-6939
Country : US
Telephone Number : 858-333-6856
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2013
Last Update Date : 08/09/2022

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Directions to “ TESSA RITCHIE ” Practice Location

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