| Jill Marie Ridens, RN, RD | |
|
511 N Brookhurst St Ste 200, Anaheim, CA 92801-5229 | |
| (714) 780-0750 | |
| Not Available |
| Full Name | Jill Marie Ridens |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 2 Years |
| Location | 511 N Brookhurst St Ste 200, Anaheim, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508565110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 1508565110 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Coastal Breeze Mental Health A Nursing Corporation | 5698143246 | 2 |
| Entity Name | Coastal Breeze Mental Health A Nursing Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497463491 PECOS PAC ID: 5698143246 Enrollment ID: O20221201002709 |
| Mailing Address | Practice Location Address |
|---|---|
| Jill Marie Ridens, RN, RD 511 N Brookhurst St Ste 200, Anaheim, CA 92801-5229 Ph: (714) 780-0750 | Jill Marie Ridens, RN, RD 511 N Brookhurst St Ste 200, Anaheim, CA 92801-5229 Ph: (714) 780-0750 |
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