Provider Demographics
NPI:1417507070
Name:MATTHEWS, RITA L
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:L
Last Name:MATTHEWS
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 1:208 CALDWELL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-5401
Mailing Address - Country:US
Mailing Address - Phone:408-515-6369
Mailing Address - Fax:
Practice Address - Street 1:208 CALDWELL AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-5401
Practice Address - Country:US
Practice Address - Phone:408-515-6369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health