Provider Demographics
NPI:1871348474
Name:RIBEIRO, CHRISTIAN R (ASW)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:R
Last Name:RIBEIRO
Suffix:
Gender:M
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8506
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-8506
Mailing Address - Country:US
Mailing Address - Phone:530-528-2342
Mailing Address - Fax:
Practice Address - Street 1:22425 SUNBRIGHT AVE
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-9741
Practice Address - Country:US
Practice Address - Phone:530-528-2342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106045101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health