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NPI 1013737196

NPI 1013737196 : GINA RIOS LMFT : NEWPORT BEACH, CA

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General NPI Number Information
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    NPI Number           |    1013737196
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    Entity Type          |    Individual 
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    Provider Name        |    GINA RIOS LMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/14/2024
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    Last Update Date     |    11/02/2024
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Provider Practice Location Address
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    Address Line         |    270 CAGNEY LN 
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    City                 |    NEWPORT BEACH
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    State                |    CA
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    Zip                  |    92663-2673
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    Country              |    US
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    Telephone            |    949-637-9332
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    270 CAGNEY LN 
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    City                 |    NEWPORT BEACH
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    State                |    CA
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    Zip                  |    92663-2673
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    149960
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    License Number State |    CA
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