Individual provider Active NPI

Michael Wyndham Ridgway, LPCC

  • Professional Counselor
  • Sunnyvale, CA
National Provider Identifier
1174936827
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5977 Issued in CA
Practice address
365 Stowell Ave
Sunnyvale, CA 94085-4316
Phone
(408) 829-2326
NPI assigned
Jun 10, 2014
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5977 CA Primary

Addresses

Primary practice location

365 Stowell Ave
Sunnyvale, CA 94085-4316

Mailing address

209 E Java Dr Unit 62513
Sunnyvale, CA 94088-8026
Phone (408) 701-7722

Other practice location 1

2001 The Alameda
San Jose, CA 95126-1136
Phone (408) 261-7777

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

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1174936827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E JAVA DR UNIT 62513",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940888026",
            "telephone_number": "408-701-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 STOWELL AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940854316",
            "telephone_number": "408-829-2326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 The Alameda",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951261136",
            "country_code": "US",
            "telephone_number": "408-261-7777",
            "fax_number": "408-259-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDGWAY",
        "first_name": "MICHAEL",
        "middle_name": "WYNDHAM",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "5977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.