MEDICARE: PAMELA RIGGS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1760723860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA RIGGS

Provider Business Mailing Address
First Line	:	311 BOLLING CIR
Second Line	:
City	:	NOVATO
State	:	CA
Zip	:	94949-4545
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 SAN ANSELMO AVE
Second Line	:	SUITE B
City	:	SAN ANSELMO
State	:	CA
Zip	:	94960-2842
Country	:	US
Telephone Number	:	888-945-6887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2013
Last Update Date	:	03/14/2013

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Directions to “ PAMELA RIGGS ” Practice Location

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