Healthcare Provider Details

I. General information

NPI: 1356124390
Provider Name (Legal Business Name): RILEY ELIZABETH KALINOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CONCORD AVE STE #185
CONCORD CA
94520-5006
US

IV. Provider business mailing address

635 E NEW HAVEN AVE STE 807
MELBOURNE FL
32901-5550
US

V. Phone/Fax

Practice location:
  • Phone: 572-208-4537
  • Fax:
Mailing address:
  • Phone: 224-258-1407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: