Healthcare Provider Details

I. General information

NPI: 1518433127
Provider Name (Legal Business Name): RICHA TIWARI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 S STRATFORD AVE STE B
SANTA MARIA CA
93454-5908
US

IV. Provider business mailing address

316 S STRATFORD AVE STE B
SANTA MARIA CA
93454-5908
US

V. Phone/Fax

Practice location:
  • Phone: 805-332-8446
  • Fax:
Mailing address:
  • Phone: 805-354-7101
  • Fax: 805-332-8173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: