Healthcare Provider Details

I. General information

NPI: 1366387086
Provider Name (Legal Business Name): RIVERBEND PSYCHOTHERAPY, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 PROVIDENCE MINE RD STE 122
NEVADA CITY CA
95959-2955
US

IV. Provider business mailing address

208 PROVIDENCE MINE RD STE 122
NEVADA CITY CA
95959-2955
US

V. Phone/Fax

Practice location:
  • Phone: 530-208-3091
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW DUARTE
Title or Position: PRESIDENT
Credential:
Phone: 530-208-3091