DEVONDRA RIDDICK (NPI# 1073160461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073160461 |
| Entity Type | Individual |
| Full Name | DEVONDRA RIDDICK |
| Practice Address |
402 E Main St Waterbury CT 06702-1701 |
| Mailing Address |
141 E Main St Fl 4 Waterbury CT 06702-2310 |
| Practice Telephone | 2037551143 |
| Practice Fax Number | 2037533274 |
| Mailing Telephone | 2035749000 |
| Mailing Fax Number | 2035749006 |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
402 E MAIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06702-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235743469 | Alisha Sanders | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2020-09-04 |
| 1275147472 | Cody Helgesen | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2020-09-04 |
| 1952913006 | Christine Cagle | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2020-08-20 |
| 1518579804 | George Ramos | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2020-08-19 |
| 1083237861 | Shalima Abdalla | Physician Assistant | 402 E Main St, Waterbury, CT 06702-1701 | 2020-05-27 |
| 1295360469 | Yvette Bonilla | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2020-03-09 |
| 1730714270 | Bryam Silva | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2020-03-05 |
| 1396379665 | Kristina Johnson | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2020-02-26 |
| 1972135143 | Geovanny Gallegos | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2020-02-06 |
| 1821630211 | Leskia Vazquez | Student in an Organized Health Care Education/Training Program | 402 E Main St, Waterbury, CT 06702-1701 | 2019-10-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780120295 | Melitza Velez | Counselor | 80 Prospect St., Waterbury, CT 06702 | 2017-01-09 |
| 1467813600 | Ashley Joseph | Counselor | 30 Holmes Ave, Waterbury, CT 06702 | 2016-03-16 |
| 1649662313 | Lori Arens | Social Worker | 141 E Main St Fl 4, Waterbury, CT 06702 | 2015-03-04 |
| 1265725584 | Zelda Shleifer | Audiologist | 21 W Main St Fl Place-3, Waterbury, CT 06702 | 2011-05-19 |
| 1700024585 | Charlene Angela Jurgaitis | Durable Medical Equipment & Medical Supplies | 102 Grand Street, Waterbury, CT 06702 | 2009-02-02 |
| 1518090570 | Nathan Z Imre | Pharmacist | 161 East Main St Central Pharmacy, Waterbury, CT 06702 | 2007-03-13 |
| 1922149467 | Rachael A Petitti | Social Worker | 402 East Main Street, Waterbury, CT 06702 | 2007-02-09 |
| 1710024484 | Abbot Terrace Health Center | Assisted Living Facility | 44 Abbott Terrace, Waterbury, CT 06702 | 2007-01-31 |
| 1205994555 | Michael Arcangel Padilla | Social Worker | Western Connecticut Mental Health Network, 55 West Main Street Suite 410, Waterbury, CT 06702 | 2006-12-05 |
| 1205902723 | Colette M Anderson | Social Worker | 55 West Main St Suite 410, Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-27 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033748975 | Anxhela Kulla | Student in an Organized Health Care Education/Training Program | 93 Cedar Ave, Waterbury, CT 06705-2702 | 2020-04-03 |
| 1902433766 | Zuhal Gokturk | Student in an Organized Health Care Education/Training Program | 56 Franklin St Dept Of, Waterbury, CT 06706-1253 | 2020-03-23 |
| 1952864787 | Sidhant Singh | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 | 2019-04-09 |
| 1699272625 | Behnoud Baradaran Noveiry | Student in an Organized Health Care Education/Training Program | 56 Franklin St Ste 1, Waterbury, CT 06706-1281 | 2018-04-06 |
| 1548766959 | Caroline Johnssen | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 | 2018-04-04 |
| 1770938508 | Andrew Camacho | Student in an Organized Health Care Education/Training Program | 160 Robbins St., Chase Outpatient Center, Waterbury, CT 06708-2613 | 2016-04-29 |
| 1134591605 | Christine Oliver | Student in an Organized Health Care Education/Training Program | 54 South Main Street, Newtown Clinical Services, Waterbury, CT 06710-2169 | 2015-10-23 |
| 1861893026 | Gopi Durlabhji Ukani | Student in an Organized Health Care Education/Training Program | 59 Sharon Rd Apt 6, Waterbury, CT 06705-4032 | 2014-09-08 |
| 1073874202 | Dykea Torres | Student in an Organized Health Care Education/Training Program | 79 Beacon Street, Waterbury, CT 06704-1701 | 2012-06-05 |
| 1750570222 | Camera Aquila Quebec | Student in an Organized Health Care Education/Training Program | 182 Grand St Fl 4, Waterbury, CT 06702-1914 | 2007-10-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.