Provider Demographics
NPI:1619369642
Name:RIOS-DAMACIO, ANA KARINA (MS)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:KARINA
Last Name:RIOS-DAMACIO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6083 N FIGARDEN DR # 635
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-3226
Mailing Address - Country:US
Mailing Address - Phone:559-341-9470
Mailing Address - Fax:
Practice Address - Street 1:412 F ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3409
Practice Address - Country:US
Practice Address - Phone:559-498-6988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-27
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC10911101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional