Provider Demographics
NPI:1215153994
Name:RITTENHOUSE, KIMBERLEY (MS, PHD)
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:RITTENHOUSE
Suffix:
Gender:F
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 DAISY CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1626
Mailing Address - Country:US
Mailing Address - Phone:408-371-7111
Mailing Address - Fax:408-371-1166
Practice Address - Street 1:5300 MCCONNELL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-7026
Practice Address - Country:US
Practice Address - Phone:310-482-5622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99265170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS