Healthcare Provider Details

I. General information

NPI: 1962778035
Provider Name (Legal Business Name): SAUL RIOS-JIMENEZ LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 6TH ST
WASCO CA
93280-1948
US

IV. Provider business mailing address

820 6TH ST
WASCO CA
93280-1948
US

V. Phone/Fax

Practice location:
  • Phone: 661-758-4029
  • Fax: 661-758-0891
Mailing address:
  • Phone: 661-758-4029
  • Fax: 661-758-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152332
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: