Provider Demographics
NPI:1134477359
Name:RILES PARZEN, ELISABETH MARGUERITE
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:MARGUERITE
Last Name:RILES PARZEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 AMIFORD DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-4205
Mailing Address - Country:US
Mailing Address - Phone:619-987-8693
Mailing Address - Fax:
Practice Address - Street 1:851 AMIFORD DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-4205
Practice Address - Country:US
Practice Address - Phone:619-987-8693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA551399163W00000X
CA10526363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse