1811099146 NPI number — MRS. ALICIA DIAZ RIOS LCSW

Table of content: MRS. ALICIA DIAZ RIOS LCSW (NPI 1811099146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811099146 NPI number — MRS. ALICIA DIAZ RIOS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIOS
Provider First Name:
ALICIA
Provider Middle Name:
DIAZ
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811099146
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 1051
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-342-4516
Provider Business Mailing Address Fax Number:
760-347-1837

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
81711 US HIGHWAY 111
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
INDIO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92201-9785
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-342-4516
Provider Business Practice Location Address Fax Number:
760-347-1837
Provider Enumeration Date:
09/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCS 9215 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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