Individual
JACQULYN DANIELLE RIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4604 W DOUGLAS AVE APT 103, VISALIA, CA 93291-4195
(559) 909-7430
Mailing address
4604 W DOUGLAS AVE APT 103, VISALIA, CA 93291-4195
(559) 909-7430
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90589009E
—
CA
Enumeration date
10/26/2020
Last updated
10/26/2020
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