RYAN THEBO NPI 1043761141

NPI Information

NPI: 1043761141
Provider Name: RYAN THEBO
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
8880 RIO SAN DIEGO DR STE 800
SAN DIEGO, CA
ZIP 92108
Phone: (619) 363-6570
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Ryan Thebo is a psychiatric/mental health nurse practitioner in San Diego, CA. Ryan Thebo NPI is 1043761141. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8880 RIO SAN DIEGO DR STE 800
SAN DIEGO, CA
ZIP 92108-642
Phone: (619) 363-6570

The NPI 1043761141 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 10/24/2016 and was last updated on 6/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	95003068	CALIFORNIA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	95003068	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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