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NPI Code Detail

MEDICARE: RENEE RIOS LCSW

MEDICARE: RENEE RIOS LCSW
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
11041C0700XClinical Social Worker117640CA
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1548782071
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE RIOS LCSW
Provider Business Mailing Address
First Line : PO BOX 341522
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-9522
Country : US
Telephone Number : 619-602-3495
Fax Number :
Provider Business Practice Location Address
First Line : 400 CORPORATE POINTE STE 300
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-7620
Country : US
Telephone Number : 619-602-3495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2017
Last Update Date : 07/17/2024

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