Provider Demographics
NPI:1174771158
Name:RISINGER, RAINA MARIE
Entity type:Individual
Prefix:MS
First Name:RAINA
Middle Name:MARIE
Last Name:RISINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8018 POCKET RD
Mailing Address - Street 2:APT 339
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5807
Mailing Address - Country:US
Mailing Address - Phone:916-422-3041
Mailing Address - Fax:
Practice Address - Street 1:8018 POCKET RD
Practice Address - Street 2:APT 339
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-5807
Practice Address - Country:US
Practice Address - Phone:916-422-3041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)