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General NPI Number Information
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NPI Number | 1730444134
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Entity Type | Organization
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Legal Business Name | RIDGEVIEW ENTERPRISES
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 1015 BEECAVE WOODS DR SUITE 207E
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City | AUSTIN
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State | TX
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Zip | 78746-6762
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Country | US
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Telephone | 512-328-3900
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Fax | 512-328-3902
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Provider Business Mailing Address
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Address Line | 1015 BEECAVE WOODS DR SUITE 207E
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City | AUSTIN
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State | TX
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Zip | 78746-6762
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Country | US
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Telephone | 512-328-3900
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Fax | 512-328-3902
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Authorized Official
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Title or Position | MANAGER
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Name | DR. HANI TALEBI
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Credential | PH.D.
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Telephone | 805-252-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 34463
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 34137
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License Number State | TX
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