Provider Demographics
NPI:1558965368
Name:RIOS, KRISTEN (ACSW #85705)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:ACSW #85705
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:404 ENCINITAS BLVD APT 258
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6714
Mailing Address - Country:US
Mailing Address - Phone:562-237-8615
Mailing Address - Fax:
Practice Address - Street 1:35072 CAMINO CAPISTRANO
Practice Address - Street 2:
Practice Address - City:CAPISTRANO BEACH
Practice Address - State:CA
Practice Address - Zip Code:92624-1731
Practice Address - Country:US
Practice Address - Phone:949-694-1199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker