Individual
JONATHAN RIDDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19000 HAWTHORNE BLVD STE 230, TORRANCE, CA 90503-1517
(310) 371-5151
Mailing address
2514 SPRECKELS LN, REDONDO BEACH, CA 90278-5337
(310) 374-3535
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2742
LICENSE#
CA
Enumeration date
11/07/2006
Last updated
07/23/2010
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