Healthcare Provider Details

I. General information

NPI: 1609288422
Provider Name (Legal Business Name): MRS. MARIA BRAVO RIZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 05/23/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N HAYES AVE
DINUBA CA
93618-3157
US

IV. Provider business mailing address

1327 E EL MONTE WAY
DINUBA CA
93618-1825
US

V. Phone/Fax

Practice location:
  • Phone: 559-595-7252
  • Fax: 559-595-8158
Mailing address:
  • Phone: 559-595-7380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number60678
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number60678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: