Healthcare Provider Details

I. General information

NPI: 1548514227
Provider Name (Legal Business Name): CATHLEEN MARIE RIDDLEY MHRS, M.A., CI/CT,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2012
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FRANKLIN STREET
SAN FRANCISCO CA
94109-4523
US

IV. Provider business mailing address

1500 FRANKLIN STREET
SAN FRANCISCO CA
94109-4523
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-7310
  • Fax: 415-255-5849
Mailing address:
  • Phone: 415-474-7310
  • Fax: 415-255-5849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: