Provider Demographics
NPI:1497325906
Name:RIFORMO, MARIA PLANAS
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:PLANAS
Last Name:RIFORMO
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 1:3831 LA COLINA RD
Mailing Address - Street 2:
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2913
Mailing Address - Country:US
Mailing Address - Phone:510-734-3890
Mailing Address - Fax:510-223-7996
Practice Address - Street 1:2430 BANCROFT LN
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3104
Practice Address - Country:US
Practice Address - Phone:510-222-4109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA075601208310400000X
CA075600176310400000X
CA071441217310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility