Gina Kim Riedl, LPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

340077AN Issued in CA

Practice address

8725 Watt Ave
Antelope, CA 95843-9747

Phone

(916) 338-6449

Fax

(916) 338-7535

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pathways to Strong Families, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Antelope, CA
  • NPI 1790862720
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013095843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 MUIRFIELD CT",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956482403",
            "telephone_number": "916-223-5778",
            "fax_number": "916-338-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 WATT AVE",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958439747",
            "telephone_number": "916-338-6449",
            "fax_number": "916-338-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDL",
        "first_name": "GINA",
        "middle_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "340077AN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DRUG MEDI-CAL#",
            "identifier": "3464",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHIATRIC TECH",
            "identifier": "PT 26123",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Ramsey
• Rajinder Singh Randhawa, M.D.
• Res-Care California, Inc.
• Res-Care California, Inc.
• Rescare California, Inc.
• Rite Aid
• Deron David Rodriguez, MS, CCC-SLP
• Kelly D Rodriguez
• Tracey Rowe
• Mina L. Rucker, MFTI

• Addiction (Substance Use Disorder) Counselor in Antelope, CA
• Providers in Antelope, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.