Healthcare Provider Details

I. General information

NPI: 1053082537
Provider Name (Legal Business Name): JUANITA DIANNA RIZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 DELA VINA AVE
MONTEREY CA
93940-3974
US

IV. Provider business mailing address

8907 LA RIVIERA DR
SACRAMENTO CA
95826-2155
US

V. Phone/Fax

Practice location:
  • Phone: 831-440-7030
  • Fax:
Mailing address:
  • Phone: 707-301-9102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number141573
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: