Robert Riddell

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY28463 Issued in CA

Practice address

3632 Sacramento St Ste 5
San Francisco, CA 94118-1710

Phone

(415) 967-0840

NPI assigned

Jul 29, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556928000000",
    "number": "1053864645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 SACRAMENTO ST STE 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181710",
            "telephone_number": "415-967-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 SACRAMENTO ST STE 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181710",
            "telephone_number": "415-967-0840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3641 Sacramento St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941181722",
            "country_code": "US",
            "telephone_number": "415-538-0377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDELL",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-29",
        "last_updated": "2019-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne Rickman
• Betty Ann Ricks
• Ricky Fishman & Barbara Rinkoff, PTR
• Philip M Rico II, BA
• Ephraim Riday
• Shadrick Riddick
• Caroline Marie Riddle, MD
• Cathleen Marie Riddley, MHRS, M.A., CI/CT,
• Emily Rider-Longmaid, MD
• Dean Loller Rider, MD

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.