Provider Demographics
NPI:1083874804
Name:RIOS, ANDREW JAMES
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAMES
Last Name:RIOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 MORRO RD
Mailing Address - Street 2:SUITE-D
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4142
Mailing Address - Country:US
Mailing Address - Phone:805-461-5212
Mailing Address - Fax:805-461-5873
Practice Address - Street 1:6500 MORRO RD
Practice Address - Street 2:SUITE-D
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4142
Practice Address - Country:US
Practice Address - Phone:805-461-5212
Practice Address - Fax:805-461-5873
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)