Provider Demographics
NPI:1851756225
Name:RILEY, DEBRA DEE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:DEE
Last Name:RILEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24800 CHRISANTA DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4833
Mailing Address - Country:US
Mailing Address - Phone:805-886-6921
Mailing Address - Fax:949-481-4145
Practice Address - Street 1:24800 CHRISANTA DR
Practice Address - Street 2:SUITE 220
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4833
Practice Address - Country:US
Practice Address - Phone:805-886-6921
Practice Address - Fax:949-481-4145
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT45262101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health