Individual
AMANDA T RIVERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1096 CALIMESA BLVD, CALIMESA, CA 92320-1563
(909) 372-0683
Mailing address
1096 CALIMESA BLVD, CALIMESA, CA 92320-1563
(909) 372-0683
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
147816
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/20/2017
Last updated
07/08/2024
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