Provider Demographics
NPI:1588299242
Name:TRI-NIA BEHAVIOR HEALTH SERVICE
Entity type:Organization
Organization Name:TRI-NIA BEHAVIOR HEALTH SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:RAMIREZ
Authorized Official - Last Name:ANDALON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:209-502-7373
Mailing Address - Street 1:6622 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:RIVERBANK
Mailing Address - State:CA
Mailing Address - Zip Code:95367-2304
Mailing Address - Country:US
Mailing Address - Phone:209-502-7373
Mailing Address - Fax:209-269-3225
Practice Address - Street 1:6622 3RD STREET
Practice Address - Street 2:
Practice Address - City:RIVERBANK
Practice Address - State:CA
Practice Address - Zip Code:95367-2304
Practice Address - Country:US
Practice Address - Phone:209-502-7373
Practice Address - Fax:209-269-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty