Individual provider Active NPI

Marjorie Ann Skinner-Riley, M.S. HCA, PA-C

  • Physician Assistant
  • Compton, CA
National Provider Identifier
1053454967
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14132 Issued in CA
Practice address
403 S Long Beach Blvd
Suite B
Compton, CA 90221-3449
Phone
(323) 774-6551
Fax
(310) 763-2315
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14132 CA Primary

Addresses

Primary practice location

403 S Long Beach Blvd
Suite B
Compton, CA 90221-3449

Mailing address

5811 S Corning Ave
Los Angeles, CA 90056-1401
Phone (310) 568-8602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PA14132CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053454967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 S CORNING AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561401",
            "telephone_number": "310-568-8602",
            "fax_number": "310-568-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 S LONG BEACH BLVD",
            "address_2": "SUITE B",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902213449",
            "telephone_number": "323-774-6551",
            "fax_number": "310-763-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER-RILEY",
        "first_name": "MARJORIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S. HCA, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

  • 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.