Provider Demographics
NPI:1568835833
Name:RIORDAN, BRIGID MARIE (NP-C)
Entity Type:Individual
Prefix:
First Name:BRIGID
Middle Name:MARIE
Last Name:RIORDAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 TOWN AND COUNTRY DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3611
Mailing Address - Country:US
Mailing Address - Phone:951-737-8141
Mailing Address - Fax:951-817-1759
Practice Address - Street 1:1901 TOWN AND COUNTRY DR
Practice Address - Street 2:SUITE 104
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3611
Practice Address - Country:US
Practice Address - Phone:951-737-8141
Practice Address - Fax:951-817-1759
Is Sole Proprietor?:No
Enumeration Date:2015-11-08
Last Update Date:2015-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003364363L00000X, 363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology