Provider Demographics
NPI:1477789063
Name:RICE, TOREY JONELL (MS)
Entity Type:Individual
Prefix:MRS
First Name:TOREY
Middle Name:JONELL
Last Name:RICE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TOREY
Other - Middle Name:JONELL
Other - Last Name:WICKLIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TOREY WICKLIFFE
Mailing Address - Street 1:401 VERNON ST STE B
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2600
Mailing Address - Country:US
Mailing Address - Phone:559-799-6574
Mailing Address - Fax:
Practice Address - Street 1:401 VERNON ST STE B
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2600
Practice Address - Country:US
Practice Address - Phone:559-799-6574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA53977106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA942519001OtherRIVER OAKS CENTER FOR CHILDREN