Active NPI
Yvonka De Ridder
- Marriage & Family Therapist
- Tampa, FL
National Provider Identifier
1255753604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMT1814
- Practice address
- 3825 Henderson Blvd
Suite 405
Tampa, FL 33629-5037 - Phone
- (813) 393-0859
- Fax
- (888) 965-9109
- NPI assigned
- Jan 19, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMT1814 | FL | Primary |
Addresses
Primary practice location
3825 Henderson Blvd
Suite 405
Tampa, FL 33629-5037
Mailing address
PO Box 10802
Tampa, FL 33679-0802
Phone (813) 393-0859
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMT1814 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390089600000",
"number": "1255753604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10802",
"city": "TAMPA",
"state": "FL",
"postal_code": "336790802",
"telephone_number": "813-393-0859",
"fax_number": "888-965-9109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3825 HENDERSON BLVD",
"address_2": "SUITE 405",
"city": "TAMPA",
"state": "FL",
"postal_code": "336295037",
"telephone_number": "813-393-0859",
"fax_number": "888-965-9109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE RIDDER",
"first_name": "YVONKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-19",
"last_updated": "2014-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "IMT1814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.