Provider Demographics
NPI:1275213233
Name:RIVERS, MALIK AMIN
Entity Type:Individual
Prefix:MR
First Name:MALIK
Middle Name:AMIN
Last Name:RIVERS
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 1:45511 ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-2263
Mailing Address - Country:US
Mailing Address - Phone:661-547-4761
Mailing Address - Fax:
Practice Address - Street 1:45511 ROBINSON DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-2263
Practice Address - Country:US
Practice Address - Phone:661-547-4761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)