MEDICARE: BRIANNA EILEEN DEL RIO

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1821650359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA EILEEN DEL RIO

Provider Business Mailing Address
First Line	:	11868 JASMINE PL
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92337-0543
Country	:	US
Telephone Number	:	909-587-0337
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 EXCISE AVE
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91761-8554
Country	:	US
Telephone Number	:	888-805-0759
Fax Number	:

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

Provider Enumeration Date	:	07/04/2019
Last Update Date	:	07/04/2019

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Directions to “ BRIANNA EILEEN DEL RIO ” Practice Location

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