Provider Demographics
NPI:1760613608
Name:RIDDER, GISELA MARIA (OTRL)
Entity Type:Individual
Prefix:MS
First Name:GISELA
Middle Name:MARIA
Last Name:RIDDER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44489 TOWN CENTER WAY
Mailing Address - Street 2:D 275
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2723
Mailing Address - Country:US
Mailing Address - Phone:760-567-0834
Mailing Address - Fax:
Practice Address - Street 1:1900 E TAHQUITZ CANYON WAY
Practice Address - Street 2:SUITE B4
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7024
Practice Address - Country:US
Practice Address - Phone:760-323-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1797225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist