MARIBETH RIDAY (NPI# 1720241474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720241474 |
| Entity Type | Individual |
| Full Name | MARIBETH RIDAY |
| Credential | RN, MSN, RDH |
| Practice Address |
1430 Freedom Blvd Ste B Watsonville CA 95076-2780 |
| Mailing Address |
1400 Emeline Ave Santa Cruz CA 95060-1976 |
| Practice Telephone | 8317638200 |
| Practice Fax Number | 8314544663 |
| Mailing Telephone | 8314544170 |
| Mailing Fax Number | 8314544663 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2015-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 697504 | CA | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
18870 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NURSE PRACTITIONER FURNISHING LICENSE | 18870 | 01 |
| CA | SANTA CRUZ COUNTY MEDICAID GROUP NUMBER | FHC40044F | 01 |
| CA | ANCC B CERTIFICATION# | 2012001567 | 01 |
| CA | SANTA CRUZ COUNTY MEDICARE GROUP PTAN# | ZZZ92069Z | 01 |
| CA | SANTA CRUZ COUNTY MEDICARE GROUP PTAN# | ZZZ91891Z | 01 |
| CA | SANTA CRUZ COUNTY MEDICARE GROUP PTAN# | ZZZ91892Z | 01 |
| Street Address |
1430 FREEDOM BLVD STE B |
| City | WATSONVILLE |
| State | CA |
| Zip Code | 95076-2780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757515 | Vicky E Gonzalez | Case Manager/Care Coordinator | 2714 Freedom Blvrd, Watsonville, CA 95076 | 2019-02-28 |
| 1861987059 | Encompass Community Services | Community/Behavioral Health | 2714 Freedom Blvd., Freedom, CA 95076 | 2018-06-29 |
| 1134617798 | Haven of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 107 Pauline Dr, Watsonville, CA 95076 | 2018-04-28 |
| 1346743911 | Kathleen Long | Physician Assistant | 2468, 75 Nielson St, Watsonville, CA 95076 | 2018-03-09 |
| 1811403603 | Hieu Thi Thanh Nguyen Boulom | Pharmacist | 2810 Freedom Blvd, Watsonview, CA 95076 | 2017-12-16 |
| 1649798398 | Jonathon Rank | Counselor | 335 East Lake Ave, Watsonville, CA 95076 | 2017-09-01 |
| 1841653318 | Cristina Guzman | Registered Nurse | 195 Aviation Way, Ste 200, Watsonville, CA 95076 | 2016-04-01 |
| 1013388974 | Salud Para La Gente | Clinic/Center | 195 Aviation Way, Suite 200, Watsonville, CA 95076 | 2015-10-16 |
| 1386025757 | Yaseer Yousuf Parupia | Podiatrist | 47 Penny Lane, Suite 1, Watsonville, CA 95076 | 2015-06-11 |
| 1093100935 | Diana Perezchica | Counselor | 20716 Freedom Blv, Watsonville, CA 95076 | 2015-03-30 |
| Find all providers in zip 95076 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154573 | Marcus Jang | Nurse Practitioner | 1130 E Colorado St Apt 214, Glendale, CA 91205-2092 | 2020-11-04 |
| 1033718580 | John Sylvanus Allieu Sr. | Nurse Practitioner | 2672 Merganser Ct, Los Banos, CA 93635-9473 | 2020-10-25 |
| 1316546930 | Chika U Oguagha | Nurse Practitioner | 16240 Carmine St, Fontana, CA 92336-1481 | 2020-10-23 |
| 1215534888 | Rosa Maria Aguero | Nurse Practitioner | 9841 Alburtis Ave Unit 29, Santa Fe Springs, CA 90670-3264 | 2020-10-06 |
| 1134726995 | Margarita Maghtesyan | Nurse Practitioner | 20251 Ventura Blvd Ste A, Woodland Hills, CA 91364-2564 | 2020-10-05 |
| 1043827140 | April Lopez Ortiz | Nurse Practitioner | 500 W Ashland Ct, Visalia, CA 93277-6609 | 2020-09-23 |
| 1477167666 | David Joseph Russell | Nurse Practitioner | 17846 Glenwood Rd, Manteca, CA 95336-9521 | 2020-09-03 |
| 1194339382 | Albert Liu | Nurse Practitioner | 43559 Southerland Way, Fremont, CA 94539-5931 | 2020-09-03 |
| 1407469554 | Andre Alexandrian | Nurse Practitioner | 1606 Winona Ave, Burbank, CA 91504-2823 | 2020-08-28 |
| 1790398238 | Heather Richardson | Nurse Practitioner | 112 S Park St Ste 1, San Francisco, CA 94107-1809 | 2020-08-25 |
| Find all providers with the same taxonomy | ||||
| City | WATSONVILLE |
| Zip Code | 95076 |
Please comment or provide details below to improve the information on MARIBETH RIDAY.
| 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.