Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 4333 | CA |
NPI | 1417169897 |
---|---|
Provider Name | Maya K Ricci |
First Address | Visalia, CA 93291-6206 |
Second Address | Visalia, CA 93291-6206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2007 |
Last Update Date | 27/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0067850 | (05) | CA |