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General NPI Number Information
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NPI Number | 1417370032
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Entity Type | Organization
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Legal Business Name | RITTER CENTER
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 07/29/2016
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Provider Practice Location Address
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Address Line | 16 RITTER ST
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3323
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Country | US
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Telephone | 415-457-8182
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3517
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City | SAN RAFAEL
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State | CA
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Zip | 94912-3517
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Country | US
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Telephone | 415-457-8182
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/CMO
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Name | MS. CIA T BYRNES
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Credential | FNP-C
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Telephone | 415-457-8182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 110000522
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License Number State | CA
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