Individual
MR. JAMES PHILIP RIDDEL JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RN, MS, CPNP
Contact information
Practice address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3853
Mailing address
290 VERNON ST, OAKLAND, CA 94610-4131
(510) 451-3818
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN478430 NP9272
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP0092720
MEDI-CAL PROVIDER
CA
Enumeration date
07/29/2005
Last updated
07/08/2007
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