Healthcare Provider Details

I. General information

NPI: 1851981047
Provider Name (Legal Business Name): MELISSA RIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10824 OLSON DR STE C #245
RANCHO CORDOVA CA
95670-5651
US

IV. Provider business mailing address

10824 OLSON DR STE C #245
RANCHO CORDOVA CA
95670-5651
US

V. Phone/Fax

Practice location:
  • Phone: 916-857-3992
  • Fax:
Mailing address:
  • Phone: 916-857-3992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT150812
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: