Provider Demographics
NPI:1083910319
Name:RIEKER, PAUL (HYPNOTHERAPIST)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:RIEKER
Suffix:
Gender:M
Credentials:HYPNOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42145 LYNDIE LANE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-3787
Mailing Address - Country:US
Mailing Address - Phone:951-970-5641
Mailing Address - Fax:
Practice Address - Street 1:42145 LYNDIE LANE
Practice Address - Street 2:SUITE 124
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-3787
Practice Address - Country:US
Practice Address - Phone:951-970-5641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor