Basic Information
| Provider Information | |||||||||
| NPI: | 1891171419 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RIOS-KLEIN | ||||||||
| FirstName: | CRISTINA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 355 TUOLUMNE ST | ||||||||
| Address2: | SUITE 1200 | ||||||||
| City: | VALLEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94590 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7075535470 | ||||||||
| FaxNumber: | 7075535653 | ||||||||
| Practice Location | |||||||||
| Address1: | 355 TUOLUMNE ST | ||||||||
| Address2: | |||||||||
| City: | VALLEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945905700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7075535470 | ||||||||
| FaxNumber: | 7075535653 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2015 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCSW15225 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.