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General NPI Number Information
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NPI Number | 1760302111
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Entity Type | Organization
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Legal Business Name | ROOTED AND RISING PSYCHOLOGY
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 1620 5TH AVE STE 800
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City | SAN DIEGO
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State | CA
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Zip | 92101-2792
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Country | US
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Telephone | 619-330-9195
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Fax | 619-330-7699
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Provider Business Mailing Address
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Address Line | PO BOX 120126
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City | SAN DIEGO
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State | CA
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Zip | 92112-0126
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Country | US
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Telephone | 619-330-9195
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Fax | 619-330-7699
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Authorized Official
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Title or Position | OWNER
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Name | BARTELL RIVERA
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Credential | PSY.D.
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Telephone | 619-330-9195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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