Healthcare Provider Details
I. General information
NPI: 1598378572
Provider Name (Legal Business Name): PAUL DANIEL RIOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/28/2020
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2280 DIAMOND BLVD STE 500
CONCORD CA
94520-5719
US
IV. Provider business mailing address
2280 DIAMOND BLVD STE 500
CONCORD CA
94520-5719
US
V. Phone/Fax
- Phone: 925-483-2223
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: