Provider Demographics
NPI:1891924148
Name:RIESS, DAVID ALLAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLAN
Last Name:RIESS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 H ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5134
Mailing Address - Country:US
Mailing Address - Phone:661-565-0287
Mailing Address - Fax:
Practice Address - Street 1:1326 H ST STE 3
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5134
Practice Address - Country:US
Practice Address - Phone:661-565-0287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW253341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical