Healthcare Provider Details

I. General information

NPI: 1417898198
Provider Name (Legal Business Name): NATHAN RICARDO RIOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 TESTOLIN RD
FALLON NV
89406-9127
US

IV. Provider business mailing address

5250 TESTOLIN RD
FALLON NV
89406-9127
US

V. Phone/Fax

Practice location:
  • Phone: 442-258-5390
  • Fax:
Mailing address:
  • Phone: 442-258-5390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: