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General NPI Number Information
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NPI Number | 1689313983
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Entity Type | Individual
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Provider Name | RYDELL L TODICHEENEY PHD, APRN, ACNS-BC
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Gender | Male
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 1305 YOSEMITE ST
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City | SEASIDE
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State | CA
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Zip | 93955-5634
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Country | US
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Telephone | 602-315-1315
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 YOSEMITE ST
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City | SEASIDE
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State | CA
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Zip | 93955-5634
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Country | US
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Telephone | 602-315-1315
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | AP7305
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 2819
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License Number State | CA
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