Healthcare Provider Details

I. General information

NPI: 1912355306
Provider Name (Legal Business Name): ROSALBA B. RIOS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13415 DOWNEY AVE
PARAMOUNT CA
90723-2303
US

IV. Provider business mailing address

13415 DOWNEY AVE
PARAMOUNT CA
90723-2303
US

V. Phone/Fax

Practice location:
  • Phone: 310-365-7306
  • Fax:
Mailing address:
  • Phone: 310-365-7306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135033
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: