MEDICARE: LINDA SUZANNE RIOS FNP

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	363LF0000X	Family Nurse Practitioner	RN302256	CA
2	363LP1700X	Perinatal Nurse Practitioner	RN302256	CA

General Provider Information

NPI Number	:	1891890992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA SUZANNE RIOS FNP

Provider Business Mailing Address
First Line	:	751 S BASCOM AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	751 S BASCOM AVE
Second Line	:	OB/GYN DEPT
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2604
Country	:	US
Telephone Number	:	408-885-5167
Fax Number	:

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	09/12/2007

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