Basic Information
| Provider Information | |||||||||
| NPI: | 1053082537 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIZO | ||||||||
| FirstName: | JUANITA | ||||||||
| MiddleName: | DIANNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9101 NEWHALL DR APT 32 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958265365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7073019102 | ||||||||
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| Practice Location | |||||||||
| Address1: | 250 EXECUTIVE PARK BLVD STE 4900 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941343335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156560116 | ||||||||
| FaxNumber: | 4156560117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2021 | ||||||||
| LastUpdateDate: | 09/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.