Rideau, Corie Zenobia
Rideau, Corie Zenobia is an individual health care provider with primary practice located at 26511 Thoroughbred Ln , Moreno Valley CA 92555-2965. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Rideau, Corie Zenobia can be contacted via phone (951) 210-5144.Contact Information
Primary practice address
26511 Thoroughbred Ln
Moreno Valley CA 92555-2965
Phone: (951) 210-5144
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Assistant | 126800000X | RDA93999 | California |
Profile Details
| NPI number | 1609476647 |
|---|---|
| LBN Legal business name | Rideau, Corie Zenobia |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 28th, 2020 |
| Last updated | Oct 28th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609476647 | NPPES |
| California | MEDICAID | B5891651 |
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