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General NPI Number Information
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NPI Number | 1306745328
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Entity Type | Organization
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Legal Business Name | UNITED STATES VETERANS INITIATIVE - RIVERSIDE
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 6235 RIVER CREST DR STE S
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City | RIVERSIDE
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State | CA
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Zip | 92507-0788
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Country | US
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Telephone | 951-200-4233
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Fax |
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Provider Business Mailing Address
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Address Line | 800 W 6TH ST STE 1505
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City | LOS ANGELES
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State | CA
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Zip | 90017-2742
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Country | US
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Telephone | 213-760-4630
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Fax |
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Authorized Official
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Title or Position | CVHI SPECIALIST
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Name | LISA R JACKSON ZENO
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Credential |
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Telephone | 213-760-4630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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