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General NPI Number Information
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NPI Number | 1568373801
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Entity Type | Organization
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Legal Business Name | BRIANNA RIDDLEBARGER, PHYSICIAN ASSISTANT INC.
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 26732 CROWN VALLEY PKWY STE 443
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6375
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Country | US
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Telephone | 949-200-7929
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Fax | 949-200-7929
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Provider Business Mailing Address
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Address Line | 38 VENETO LN
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City | ALISO VIEJO
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State | CA
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Zip | 92656-8040
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Country | US
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Telephone | 949-200-7929
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Fax | 949-200-7929
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. BRITTEN DEVEREUX
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Credential |
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Telephone | 214-306-8447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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