Healthcare Provider Details

I. General information

NPI: 1942020672
Provider Name (Legal Business Name): RIPPLE IN KIND CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 GELLERT BLVD STE 128
DALY CITY CA
94015-2694
US

IV. Provider business mailing address

333 GELLERT BLVD STE 128
DALY CITY CA
94015-2694
US

V. Phone/Fax

Practice location:
  • Phone: 415-617-5110
  • Fax:
Mailing address:
  • Phone: 415-617-5110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNA KING
Title or Position: PSYCHOLOGIST/CEO
Credential: PHD
Phone: 415-617-5110