Individual
FREDRICK L RIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 W TOKAY ST STE A, LODI, CA 95240-3965
(209) 412-2388
Mailing address
1111 W TOKAY ST STE A, LODI, CA 95240-3965
(209) 412-2388
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/21/2023
Last updated
04/28/2026
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