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General NPI Number Information
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NPI Number | 1083429047
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Entity Type | Individual
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Provider Name | MATHEW ROBERT RITCHIE
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Gender | Male
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 291 SMITH RANCH RD
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2093
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Country | US
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Telephone | 415-492-0818
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Fax |
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Provider Business Mailing Address
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Address Line | 352 S 39TH ST
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City | RICHMOND
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State | CA
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Zip | 94804-3331
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Country | US
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Telephone | 925-664-1416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1587081124
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License Number State | CA
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