Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.089970 | OH |
Y | 208000000X | Pediatrician | A132399 | CA |
N | 2080P0210X | Pediatric Nephrologist | N9122 | TX |
NPI | 1487859500 |
---|---|
Provider Name | Alyssa Ann Riley |
First Address | Modesto, CA 95355-4201 |
Second Address | Stockton, CA 95209-2839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 30/10/2014 |