Healthcare Provider Details

I. General information

NPI: 1891235040
Provider Name (Legal Business Name): CHRISTIE MARTHA RIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 N SUNOL DR STE 900
LOS ANGELES CA
90063-1429
US

IV. Provider business mailing address

17707 STUDEBAKER RD
CERRITOS CA
90703-2640
US

V. Phone/Fax

Practice location:
  • Phone: 323-768-2515
  • Fax:
Mailing address:
  • Phone: 562-467-0209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: