Provider Demographics
NPI:1538927934
Name:RIBOTA, BRIANA NEYRA (MSW)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:NEYRA
Last Name:RIBOTA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 SPRINGFIELD ST APT D
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-2980
Mailing Address - Country:US
Mailing Address - Phone:909-732-6297
Mailing Address - Fax:
Practice Address - Street 1:1409 SPRINGFIELD ST APT D
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-2980
Practice Address - Country:US
Practice Address - Phone:909-732-6297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW121154101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor