Provider Demographics
NPI:1255925202
Name:RIDLING, ALEXANDRIA LEIGH
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:LEIGH
Last Name:RIDLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 MACBETH ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3118
Mailing Address - Country:US
Mailing Address - Phone:707-337-5227
Mailing Address - Fax:
Practice Address - Street 1:2290 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-2929
Practice Address - Country:US
Practice Address - Phone:707-643-5785
Practice Address - Fax:707-643-8190
Is Sole Proprietor?:No
Enumeration Date:2021-02-21
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program