Basic Information
| Provider Information | |||||||||
| NPI: | 1417151028 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RITZLER | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Credential: | FACT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6905 WEDDIGEN WAY | ||||||||
| Address2: | |||||||||
| City: | NORTH HIGHLANDS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956603526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9162337884 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 406 SUNRISE AVE STE 310 | ||||||||
| Address2: | |||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956614106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167823737 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | FACT | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.