Provider Demographics
NPI:1003620642
Name:RIVAS FRANCO, MARIA MISHELL
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MISHELL
Last Name:RIVAS FRANCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MISHELL
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4041 CARROLL CT
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3139
Mailing Address - Country:US
Mailing Address - Phone:909-642-1437
Mailing Address - Fax:
Practice Address - Street 1:4041 CARROLL CT
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3139
Practice Address - Country:US
Practice Address - Phone:909-642-1437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health