Provider Demographics
NPI:1114321387
Name:RITNER, ANNA (LAC, FABORM)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:RITNER
Suffix:
Gender:F
Credentials:LAC, FABORM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 OLYMPIC BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5024
Mailing Address - Country:US
Mailing Address - Phone:925-268-8830
Mailing Address - Fax:
Practice Address - Street 1:1901 OLYMPIC BLVD STE 120
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5024
Practice Address - Country:US
Practice Address - Phone:925-268-8830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16299171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist