Healthcare Provider Details

I. General information

NPI: 1851201453
Provider Name (Legal Business Name): ANDREW RICE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 E BETTERAVIA RD STE 201
SANTA MARIA CA
93454-7023
US

IV. Provider business mailing address

1172 LEA DR
NOVATO CA
94945-3356
US

V. Phone/Fax

Practice location:
  • Phone: 805-621-7651
  • Fax:
Mailing address:
  • Phone: 415-408-1554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: