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NPI Code Detail

MEDICARE: MS. KATHY ANN RILEY MFT-I

MEDICARE: MS. KATHY ANN RILEY MFT-I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistIMF74967CA
2106H00000XMarriage & Family Therapist115056CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27565AOTHERCAOUTPATIENT MENTAL HEALTH

General Provider Information

NPI Number : 1356543003
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHY ANN RILEY MFT-I
Provider Business Mailing Address
First Line : 5870 ARLINGTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-2037
Country : US
Telephone Number : 951-683-6596
Fax Number :
Provider Business Practice Location Address
First Line : 5870 ARLINGTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-2037
Country : US
Telephone Number : 951-683-6596
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 03/22/2021

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