Provider Demographics
NPI:1871768358
Name:NAVARRO, RIVER QUINN MARTINEZ (LMFT)
Entity type:Individual
Prefix:MR
First Name:RIVER
Middle Name:QUINN MARTINEZ
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:DOLORES
Other - Last Name:NAVARRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5201 WHITE LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309
Mailing Address - Country:US
Mailing Address - Phone:661-241-6210
Mailing Address - Fax:661-241-6254
Practice Address - Street 1:5201 WHITE LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-241-6210
Practice Address - Fax:661-241-6254
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96344106H00000X
CAIMF82826101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist