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General NPI Number Information
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NPI Number | 1407919756
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Entity Type | Individual
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Provider Name | ALICIA JOSEPH RIVERS MFT
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 1309 EVANS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94124-1705
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Country | US
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Telephone | 415-206-7659
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Fax | 415-206-7630
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Provider Business Mailing Address
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Address Line | 7791 VIA COSTADA ST
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City | LAS VEGAS
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State | NV
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Zip | 89123-1817
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Country | US
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Telephone | 415-577-2509
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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 | 23679
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License Number State | CA
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