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General NPI Number Information
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NPI Number | 1225122039
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Entity Type | Individual
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Provider Name | RAVITA REDDY M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1801 PARK COURT PL BLDG H
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City | SANTA ANA
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State | CA
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Zip | 92701-5028
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Country | US
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Telephone | 714-957-1004
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 54252
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City | IRVINE
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State | CA
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Zip | 92619-4252
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Country | US
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Telephone | 949-413-0753
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | A85458
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License Number State | CA
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