Provider Demographics
NPI:1043396062
Name:RILEY, STEPHENIE V (ND)
Entity type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:V
Last Name:RILEY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10448 DONNER PASS RD
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-0344
Mailing Address - Country:US
Mailing Address - Phone:530-536-5066
Mailing Address - Fax:530-536-5068
Practice Address - Street 1:10448 DONNER PASS RD
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-0344
Practice Address - Country:US
Practice Address - Phone:530-536-5066
Practice Address - Fax:530-536-5068
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-17175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath