MEDICARE: RIO ANN FITZGERALD

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
1	106H00000X	Marriage & Family Therapist		CA

General Provider Information

NPI Number	:	1730051186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIO ANN FITZGERALD

Provider Business Mailing Address
First Line	:	PO BOX 940632
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93094-0632
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 PARK LN STE 110
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-2116
Country	:	US
Telephone Number	:	530-392-4399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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Directions to “ RIO ANN FITZGERALD ” Practice Location

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