Provider Demographics
NPI:1326175274
Name:ACEVEDO, ROSA LEE (LMFT)
Entity Type:Individual
Prefix:DR
First Name:ROSA LEE
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3593 ARLINGTON AVE STE J
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3935
Mailing Address - Country:US
Mailing Address - Phone:951-369-5211
Mailing Address - Fax:951-276-0482
Practice Address - Street 1:3579 ARLINGTON AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3915
Practice Address - Country:US
Practice Address - Phone:951-369-5211
Practice Address - Fax:951-276-0482
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30665106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist