Provider Demographics
NPI:1245487586
Name:RILEY, ALIDA D (LMFT)
Entity type:Individual
Prefix:MRS
First Name:ALIDA
Middle Name:D
Last Name:RILEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43700 17TH STREET WEST SUITE 202
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3236
Mailing Address - Country:US
Mailing Address - Phone:661-466-6707
Mailing Address - Fax:661-942-4285
Practice Address - Street 1:43700 17TH STREET WEST SUITE 202
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-466-6707
Practice Address - Fax:661-942-4285
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84048106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist