Provider Demographics
NPI:1215449772
Name:RITCHEY, VIRGINIA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:ANN
Last Name:RITCHEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:GINNY
Other - Middle Name:ANN
Other - Last Name:RITCHEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:9 WILDFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-2079
Mailing Address - Country:US
Mailing Address - Phone:650-740-8988
Mailing Address - Fax:
Practice Address - Street 1:9 WILDFLOWER CT
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-2079
Practice Address - Country:US
Practice Address - Phone:650-740-8988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26238103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent