Provider Demographics
NPI:1205030079
Name:RIGGIO, RACHEL THERESA
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:THERESA
Last Name:RIGGIO
Suffix:
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 1:2517 MODOC RD APT 22
Mailing Address - Street 2:SANTA BARBARA, CA 93105
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4157
Mailing Address - Country:US
Mailing Address - Phone:801-520-8718
Mailing Address - Fax:
Practice Address - Street 1:25 W ANAPAMU ST
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5148
Practice Address - Country:US
Practice Address - Phone:805-730-7575
Practice Address - Fax:805-730-7503
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UNLICENSED INTERN101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)