Provider Demographics
NPI:1912447160
Name:MUNOZ RIVERA, KENIA CITLALY
Entity type:Individual
Prefix:
First Name:KENIA
Middle Name:CITLALY
Last Name:MUNOZ RIVERA
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 1:14901 NORFOLK CIR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-7064
Mailing Address - Country:US
Mailing Address - Phone:909-329-4141
Mailing Address - Fax:
Practice Address - Street 1:7120 HAYVENHURST AVE STE 322
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3813
Practice Address - Country:US
Practice Address - Phone:800-930-5773
Practice Address - Fax:800-930-7957
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0-19-9975106E00000X
106S00000X
CA1-22-57505103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician