Individual
MR. JAMES D. RICCIARDI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1020 S MAIN ST, SALT LAKE CITY, UT 84101-3176
(801) 539-7000
(801) 539-7050
Mailing address
2454 SHADOW WOOD CIR, SALT LAKE CITY, UT 84117-6251
(801) 272-6430
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
114731-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107032404101
INTERMOUNTAIN HEALTH CARE
UT
01
—
261754
DESERET MUTUAL
UT
01
—
R34636
MEDICARE ADVANTAGE PLANS
UT
Enumeration date
12/02/2005
Last updated
07/08/2007
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