Active NPI
Kenneth Ridgeway
- School Psychologist
- Perris, CA
National Provider Identifier
1194300517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 260090955
- Practice address
- 2221 S a St Ste 101
Perris, CA 92570-9318 - Phone
- (951) 940-4942
- NPI assigned
- Mar 17, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 260090955 | CA | Primary |
Addresses
Primary practice location
2221 S a St Ste 101
Perris, CA 92570-9318
Mailing address
1254 Sunset Ave
Perris, CA 92571-3790
Phone (951) 448-9702
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": "1615939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1194300517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1254 SUNSET AVE",
"city": "PERRIS",
"state": "CA",
"postal_code": "925713790",
"telephone_number": "951-448-9702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2221 S A ST STE 101",
"city": "PERRIS",
"state": "CA",
"postal_code": "925709318",
"telephone_number": "951-940-4942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDGEWAY",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-17",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "260090955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.