Individual
NELL B. RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1838 EL CAMINO REAL, SUITE 220, BURLINGAME, CA 94010-3126
(650) 692-7396
Mailing address
1838 EL CAMINO REAL, SUITE 220, BURLINGAME, CA 94010-3126
(650) 692-7396
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY8588
CA
103T00000X
Psychologist
PSY8588
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PU0085880
MEDICAID
CA
Enumeration date
02/26/2007
Last updated
12/09/2008
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