Individual
DR. KENNETH L. RIDER
Active
Individual
DR. KENNETH L. RIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY19767
CA
103TC0700X
Clinical Psychologist
PSY19767
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109582
DIVISION OF WORKERS COMPENSATION-QME
CA
01
—
51043
NATIONAL REGISTER OF HEALTH CARE PSYCHOLOGISTS
CA
Enumeration date
05/27/2005
Last updated
02/03/2013
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