Provider Demographics
NPI:1366146292
Name:RIBERA, DELANE (AMFT)
Entity type:Individual
Prefix:
First Name:DELANE
Middle Name:
Last Name:RIBERA
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 E SHAW AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7914
Mailing Address - Country:US
Mailing Address - Phone:394-955-9202
Mailing Address - Fax:
Practice Address - Street 1:1322 E SHAW AVE STE 260
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7914
Practice Address - Country:US
Practice Address - Phone:394-955-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138612101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health