Provider Demographics
NPI:1396223012
Name:RIZO, AMANDA MARISSA (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARISSA
Last Name:RIZO
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 E 5TH ST APT 7
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-5031
Mailing Address - Country:US
Mailing Address - Phone:213-640-6848
Mailing Address - Fax:
Practice Address - Street 1:3050 E 5TH ST APT 7
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814-5031
Practice Address - Country:US
Practice Address - Phone:305-467-3157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2023-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5414101YP2500X
CA8037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional