1205995743 NPI number — ALMA C RITSEMA NP

Table of content: ALMA C RITSEMA NP (NPI 1205995743)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205995743 NPI number — ALMA C RITSEMA NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RITSEMA
Provider First Name:
ALMA
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205995743
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9515 SOQUEL DR STE 207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APTOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95003-4137
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-612-6283
Provider Business Mailing Address Fax Number:
877-677-2791

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9515 SOQUEL DR STE 207
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APTOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95003-4137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-612-6283
Provider Business Practice Location Address Fax Number:
877-677-2791
Provider Enumeration Date:
12/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  NP16769 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NPF16769 . This is a "STATE OF CALIFORNIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 16769 . This is a "NURSE PRACTICIONER LIC" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 621285 . This is a "RN LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 67264 . This is a "PUBLIC HEALTH NURSE LIC" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".