Provider Demographics
NPI:1003196064
Name:RIPALDA, JUDY T (RN)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:T
Last Name:RIPALDA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6670 GLADE AVE
Mailing Address - Street 2:APT# 103
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2541
Mailing Address - Country:US
Mailing Address - Phone:818-521-5860
Mailing Address - Fax:747-444-9271
Practice Address - Street 1:6670 GLADE AVE
Practice Address - Street 2:APT# 103
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91303-2541
Practice Address - Country:US
Practice Address - Phone:818-521-5860
Practice Address - Fax:747-444-9271
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN29192163W00000X
CA495273163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse