MEDICARE: RIKKI RAP INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	440012AP	OTHER	CA	DEPARTMENT OF HEALTH CARE SERVICES

General Provider Information

NPI Number	:	1245362979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIKKI RAP INC.

Provider Business Mailing Address
First Line	:	8030 SOQUEL AVE STE 103
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2096
Country	:	US
Telephone Number	:	831-476-1747
Fax Number	:	831-476-1125

Provider Business Practice Location Address
First Line	:	8030 SOQUEL AVE STE 103
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2096
Country	:	US
Telephone Number	:	831-476-1747
Fax Number	:	831-476-1125

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	SARAH COOPER
Credential	:
Telephone Number	:	831-476-1747

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	02/02/2016

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Directions to “RIKKI RAP INC. ” Practice Location

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