Dylan Ray Riese, RADT TRAINEE 1
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Dulzura, CA
NPI 1174480685 · NPPES record last updated Jan 7, 2026
Key facts
- NPI
- 1174480685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- RT1420931025 (CA)
- Practice address
- 18985 Highway 94
Dulzura, CA 91917-1527 - Phone
- (619) 335-2996
- NPI assigned
- Jan 7, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT1420931025 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | RT1420931025 | CA | Yes |
Addresses
Primary practice location
18985 Highway 94
Dulzura, CA 91917-1527
Mailing address
18985 Highway 94
Dulzura, CA 91917-1527
Phone (619) 335-2996
Other providers in Dulzura, CA
- Los Sauzales, Inc
- Michelle Lynn Machart
- Nicolas Luis Medellin
- Quinn Daniel Poulton
- Yvonne S Purdy-Luxton
- Barbara Sarter
- Jonathan William Treadway
- Autumn Wong
All providers in Dulzura, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.