Provider Demographics
NPI:1033265889
Name:RIOS, ROSA M I
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:M
Last Name:RIOS
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 VERSAILLES AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-4062
Mailing Address - Country:US
Mailing Address - Phone:707-259-8160
Mailing Address - Fax:
Practice Address - Street 1:2261 ELM STREET
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559
Practice Address - Country:US
Practice Address - Phone:707-259-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker