Provider Demographics
NPI:1841779790
Name:RIZZO, TIMOTHY FRANK (RNFA)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:FRANK
Last Name:RIZZO
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 VIA LORENTE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8174
Mailing Address - Country:US
Mailing Address - Phone:559-303-2371
Mailing Address - Fax:
Practice Address - Street 1:3700 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-1419
Practice Address - Country:US
Practice Address - Phone:562-531-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA377834163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant