Healthcare Provider Details

I. General information

NPI: 1952232019
Provider Name (Legal Business Name): MICHELLE DEL RIO MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 E 12TH ST
OAKLAND CA
94601-3424
US

IV. Provider business mailing address

4022 CHINABERRY DR
GARLAND TX
75043-6335
US

V. Phone/Fax

Practice location:
  • Phone: 415-889-3369
  • Fax:
Mailing address:
  • Phone: 469-865-3433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: