Provider Demographics
NPI:1912333980
Name:FOX, RICK (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RICK
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 TARTAN RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-9243
Mailing Address - Country:US
Mailing Address - Phone:209-518-3889
Mailing Address - Fax:
Practice Address - Street 1:500 W HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:FRENCH CAMP
Practice Address - State:CA
Practice Address - Zip Code:95231-9693
Practice Address - Country:US
Practice Address - Phone:209-468-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-22
Last Update Date:2022-08-08
Deactivation Date:2022-08-04
Deactivation Code:
Reactivation Date:2022-08-08
Provider Licenses
StateLicense IDTaxonomies
UT5897742-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered