Provider Demographics
NPI:1912054040
Name:RICCERI, FRANK S (BS)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:S
Last Name:RICCERI
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 15408
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-5408
Mailing Address - Country:US
Mailing Address - Phone:805-865-1940
Mailing Address - Fax:805-865-1954
Practice Address - Street 1:1112 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6608
Practice Address - Country:US
Practice Address - Phone:805-928-0139
Practice Address - Fax:805-928-1410
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health