Healthcare Provider Details

I. General information

NPI: 1922647684
Provider Name (Legal Business Name): JOSHUA RIKI TOMITA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2019
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 SPRINGHILL DR STE 300
NORTH LITTLE ROCK AR
72117-2909
US

IV. Provider business mailing address

3201 SPRINGHILL DR STE 300
NORTH LITTLE ROCK AR
72117-2909
US

V. Phone/Fax

Practice location:
  • Phone: 501-753-4132
  • Fax:
Mailing address:
  • Phone: 501-753-4132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code136A00000X
TaxonomyRegistered Dietetic Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: