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Individual

MS. ELIZABETH BENNETT RILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1441 N TRACY BLVD, TRACY, CA 95376-3445
(209) 835-8910
Mailing address
1691 THE ALAMEDA, SAN JOSE, CA 95126-2203

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2299351
MA
363LP2300X
Primary Care Nurse Practitioner
RN2299351
MA
363LW0102X
Women's Health Nurse Practitioner
Primary
95007017
CA
363LW0102X
Women's Health Nurse Practitioner
RN2299351
MA

Other

Enumeration date
03/26/2017
Last updated
02/04/2020
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