MEDICARE: CARA RYDER

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	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982899522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA RYDER

Provider Business Mailing Address
First Line	:	860 FOXRIDGE WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95133-1462
Country	:	US
Telephone Number	:	408-254-2068
Fax Number	:

Provider Business Practice Location Address
First Line	:	860 FOXRIDGE WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95133-1462
Country	:	US
Telephone Number	:	408-254-2068
Fax Number	:

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

Provider Enumeration Date	:	09/06/2007
Last Update Date	:	08/15/2012

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Directions to “ CARA RYDER ” Practice Location

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