Healthcare Provider Details

I. General information

NPI: 1093821712
Provider Name (Legal Business Name): SUSAN RITCHEY RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 MAPLE AVE
TORRANCE CA
90503-5005
US

IV. Provider business mailing address

2888 LONG BEACH BLVD SUITE 400
LONG BEACH CA
90806-1530
US

V. Phone/Fax

Practice location:
  • Phone: 310-212-3293
  • Fax:
Mailing address:
  • Phone: 562-595-5424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN305614
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: