Robert Kenneth Riedl II, PHD.,M- R.A.S., MCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

103211032 Issued in CA

Practice address

2055 Saviers Rd
Oxnard, CA 93033-3608

Phone

(805) 483-2253

NPI assigned

Nov 1, 2006

Sex

Male

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 1

Other names 1

• Dr. Ken Ken Riedl II Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Crossroads Consulting Center

  • Community/Behavioral Health Agency
  • Roseville, CA
  • NPI 1720392137
  NPD (past) Authorized official
• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Banning, CA
  • NPI 1376293407
  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": "1538006400000",
    "number": "1164500021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 SAVIERS RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930333608",
            "telephone_number": "805-483-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 SAVIERS RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930333608",
            "telephone_number": "805-483-2253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2281 Lava Ridge Ct",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956612801",
            "country_code": "US",
            "telephone_number": "916-771-3707",
            "fax_number": "916-338-7535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEDL",
        "first_name": "ROBERT",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PHD.,M- R.A.S., MCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "103211032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGITERED ADDICTION SPEC",
            "identifier": "103211032",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEN",
            "last_name": "RIEDL",
            "middle_name": "KEN",
            "prefix": "DR.",
            "suffix": "II",
            "credential": "PHD.,M- R.A.S., MCA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Richard L. Anderson, O.D., a Professional Corporation
• Wendy Rico
• Angela Patalano Riddle, LCSW
• Sarah Riddle, OTR/L
• Bonnie Ridge, FNP-BC
• Melissa Rigaud
• Ilise Ann Rignack, AMFT
• Shraddha Rikhye, DDS
• Marissa Mikal Riley
• Rio School District

• Addiction (Substance Use Disorder) Counselor in Oxnard, CA
• Providers in Oxnard, 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 Sep 27, 2018; 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.