Ryan Thebo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95003068 Issued in CA

Practice address

8880 Rio San Diego Dr Ste 800
San Diego, CA 92108-1642

Phone

(619) 363-6570

NPI assigned

Oct 24, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Peak Wellness Psychiatry, a Professional Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
  • NPI 1376184168
  NPD Authorized official

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1043761141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N BARRANCA AVE APT 20",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231722",
            "telephone_number": "888-909-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 RIO SAN DIEGO DR STE 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081642",
            "telephone_number": "619-363-6570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2510 El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920081273",
            "country_code": "US",
            "telephone_number": "760-729-8941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Silverlining Psychiatry Medical Group",
            "address_2": "3252 Holiday Ct #108",
            "address_purpose": "LOCATION",
            "city": "La Jolla",
            "state": "CA",
            "postal_code": "92037",
            "country_code": "US",
            "telephone_number": "858-230-7585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEBO",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-24",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003068",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95003068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Village Speech Therapy Inc.
• The Vulnerable Wolf a Professional Corporation
• The Way Back
• The Wellness Institute of America, LLC
• The Wellness Walker Collective
• Greg David Thedell, BSW
• Alyssa Mae Theis, LMFT#132680
• Yuridia Theis
• Kelsey Linn Theisen, RD, CLEC
• Patricia Kathleen Thelin, LVN

• Psychiatric/Mental Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.