Healthcare Provider Details

I. General information

NPI: 1407359250
Provider Name (Legal Business Name): EMMANUELLE GARCIA-RIDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMMANUELLE GARCIA

II. Dates (important events)

Enumeration Date: 03/16/2018
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5190 NEIL RD STE 215
RENO NV
89502-6509
US

IV. Provider business mailing address

1155 MILL ST # MSM14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-682-8469
  • Fax:
Mailing address:
  • Phone: 775-982-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number21434
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: