Provider Demographics
NPI:1457549321
Name:RIOS, NOREEN JOYCE (MFT)
Entity Type:Individual
Prefix:MS
First Name:NOREEN
Middle Name:JOYCE
Last Name:RIOS
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 1:4728 IROQUOIS AVE
Mailing Address - Street 2:K
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6258
Mailing Address - Country:US
Mailing Address - Phone:619-275-1125
Mailing Address - Fax:
Practice Address - Street 1:4728 IROQUOIS AVE
Practice Address - Street 2:K
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6258
Practice Address - Country:US
Practice Address - Phone:619-583-7011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM14888106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC14888OtherMARRIAGE FAMILY THERAPIST