Provider Demographics
NPI:1447564794
Name:RITKA, RIA
Entity Type:Individual
Prefix:
First Name:RIA
Middle Name:
Last Name:RITKA
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:PO BOX 2587
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-0587
Mailing Address - Country:US
Mailing Address - Phone:707-571-2215
Mailing Address - Fax:707-526-9672
Practice Address - Street 1:152 MIDDLE RINCON RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95409-3409
Practice Address - Country:US
Practice Address - Phone:707-571-2215
Practice Address - Fax:707-526-9672
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)