Basic Information
| Provider Information | |||||||||
| NPI: | 1649462441 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RIOS MUNOZ | ||||||||
| FirstName: | GRACIELA | ||||||||
| MiddleName: | EULALIA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW,LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1040 RAMONA AVE | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947062302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104283462 | ||||||||
| FaxNumber: | 5106013912 | ||||||||
| Practice Location | |||||||||
| Address1: | 5220 CLAREMONT AVE | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946181033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104283462 | ||||||||
| FaxNumber: | 5106013912 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2007 | ||||||||
| LastUpdateDate: | 08/15/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | LCS17681 | CA | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.